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Pediatric Coding Alert

E/M Coding:

99058: 'Walk-in' Patients Alone Won't Qualify You for This Emergency Code

Published on Fri Jan 13, 2012

Highlight the phrase "in addition to basic service."Pediatricians don't always see patients during scheduled office visits, which means you probably see walk-in patients almost every week. Although some practices immediately stamp a 99058 code on all walk-in claims, you should avoid adding this code to your visit unless you can prove that the patient's visit is truly emergent.Office Emergency Points to 99058Think "emergency" and "interruption" when considering whether to include 99058 (Service[s] provided on an emergency basis in the office, which disrupts other scheduled office services, in addition to basic service) on a claim."It needs to truly be an emergent or urgent problem that disrupts the physician's schedule - not lunch, but their schedule," says Richard Tuck, MD, FAAP, pediatrician at PrimeCare of Southeastern Ohio in Zanesville. "It can apply to walk-ins if they have a triage assessment and have an acute problem that needs to be worked up immediately [...]
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