Wiki After Hours Billing

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cedwards

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If a pediatric practice has office hours posted from 8-5 but indicates that they are closed from 12-1 for lunch can they bill 99050 (Services provide in office at times other than regularly scheduled office hours, or days when office is normally closed) for services that are added on during lunch (12-1) that are semi urgent such as a patient with difficulty breathing who needs a nebulizer treatment, etc.?

Thanks!
 
you can't bill that code during lunch hours. Per most provider contract with insurance carriers they list office hours but not lunch. Most providers don't get lunch because they get so far behind with scheduled patients. However, it is still within the normal scope of practice and a provider choice.

Hope this helps

Sandi CPC, CPMA
 
Afer hour codes

How do you code for after hours? Is it any hours that the office is not open? Also would you code an E/M along with the after hour codes.

Thank you so much for your help,
Teresa:)
 
Teresa,
Codes 99050 and 99051 can be a great revenue generator for your office. The CPT description is pretty detailed so check it out. You use these codes in addition to E/M, and insurances pay between $20 and $5 dollars even Medicaid. Your medical providers are already doing the work, they should be paid extra if starting early, staying late or working weekends.
 
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