General Surgery Coding Alert
Medicare Won't Recognize 'After Hours'
Question: A Medicare patient knocked on the door on a Friday when the office was closed. He was concerned that some medication the physician prescribed was having an adverse effect. The physician agreed to see the patient and performed an E/M service. May we report 99050 in addition to an office visit? Answer: Code 99050 (Services requested after posted office hours in addition to basic service) is listed as a "Status B" code in the Medicare fee schedule. This means that CMS has not assigned any relative value units to this service, and it is always bundled. Therefore, Medicare will not pay you for use of this code. Because Medicare is the payer in the scenario described, you may bill only the E/M code.
South Carolina Subscriber
But some commercial insurance companies will reimburse for 99050. Physician practices will often negotiate this code as part of their fee schedule with commercial payers.
General Surgery Coding Alert
- Are You Getting All the Payment You've Earned for Cholecystectomy?
Hint: Check for complications, open procedures Although reporting cholecystectomy is usually straightforward, you might be [...] - An ED Visit and Admission on the Same Day? Here's How
How can you code for optimal reimbursement if the surgeon sees a patient in the [...] - You Be the Coder:
Modifier -22 or Unlisted-Procedure Code?
Question: Our surgeon asks us to report procedures that take extra time and effort with [...] - Fee Schedule Update:
Higher Payments Will Boost Your Bottom Line
Once again for 2004, Congress has passed legislation that reverses a threatened reduction in Medicare [...] - If You Haven't Gone Electronic, Now's the Time
CMS final rule mandates e-claims Are you submitting Medicare claims electronically? If not, in many [...] - Reader Question:
Bill On-Call Visits as 'Established'
Question: Our physician is "on-call" for another surgeon. If he sees one of the surgeon's [...] - Reader Question:
Same-Day Observation/Discharge = 99234-99236
Question: A patient presented to the ED complaining of dizziness and nausea following a minor [...] - Reader Question:
Use Split-Thickness Codes for Keratinocytes
Question: How should I code for harvesting of keratinocytes for skin grafts?
Texas Subscriber
Answer: The appropriate [...] - Reader Question:
G-Tube Is a 'Separate' Procedure
Question: The surgeon performed both large (44140) and small (44120) bowel resection and placed a [...] - Reader Question:
Medicare Won't Recognize 'After Hours'
Question: A Medicare patient knocked on the door on a Friday when the office was [...] - Reader Question:
Select 99220 and 99217 for Multiday Observation
Question: Our surgeon treated a patient in the emergency department, and he admitted the patient [...] - Reader Question:
Report Initial Hospital Care for Admits Only
Question: I was recently called into the hospital to take over the care of a [...] - Reader Question:
Three Steps for Excision/Biopsy Coding
Question: Our surgeon obtained a partial incisional biopsy followed by excision of the same lesion. [...] - Correction
The January issue of General Surgery Coding Alert ("Have Skin Grafts Got You Guessing?" p. [...]
