Urology Coding Alert

Question: My urologist saw a patient in the office on a weekend. How should I report this?


Oregon Subscriber

Answer: You should first report the appropriate E/M service code for the visit based on the level of service your urologist provided. Then report 99050 (Services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed [e.g., holidays, Saturday or Sunday], in addition to basic service) to indicate that the visit occurred outside of your physician's regular office hours.

Downside: Medicare payers won't reimburse for "after-hours" codes 99050-99053, but you can often persuade private payers to reimburse for the services. You may be able to convince private carriers to pay by showing how after-hours visits--on an emergency basis--can benefit patients and, at the same time, reduce the cost of claims.