Wiki After hours 99050

[CRC CPC]

There has been a question that came up regarding code 99050 here it is :
if we post our hours we shouldnt use it ect.. Dr. has concerns we should not.. can you see what the belief is?
Since this is not my area I ask my fellow coders

 

[Tracey Thompson]

The description per Encoder Pro of 99050 states "Services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed (eg, holidays, Saturday or Sunday), in addition to basic service".

I would think that posting your hours would be a requirement to use this code. As in the situation that the office hours posted are Mon-Fri 8AM-5PM, but patient can not schedule an appointment, has emergency, etc and needs to be seen outside of your regularly scheduled (posted) office hours.

Just be careful not to use this code when a patient is seen outside of normal business hours due to reasons such as the physician is late, physician schedule did not allow prior appointment, or any other reason that could be considered "the physicians/office fault".

Also, keep in mind that most insurance carriers considered this a "non-covered service", which means that you would have to forward to charge for this on to the patient. Due to compliance issues, you would not be able to "write-off or adjust off" this amount when it is patient responsibility due to non-coverage by the insurance carrier.

I don't know if this answered your question, but I hope it helps!!

 

[CrysLednum]

A few times a week we have "late hours" posted "open from 11AM -8PM". If a patient comes in for a 6:30 pm visit, we do not allow our physicians to code for the After-Hours code.

But, let's say patient calls at 4:45 pm on Friday and your office closed at 4:00. Perhaps physician is still there dictating, gets call and says come on in. Then the After-Hours code would be appropriate because the normal business hours are over.

II think it's important to keep in mind what are the "normal business hours" for that DOS.