Wiki after hours / urgent care being provided in the office and run by the PA's

[hotcakesforyou@aol.com]

the practice i work for is looking to provide urgent care hours in the office. our regular office hours are 8am - 5pm, they are looking to provide the urgent care hours from 5pm - 9pm. we have been going back and forth with the two following two codes 99050 & 99051. per our research many insurance companies do not pay for these codes, they are bundled with the E&M codes.

has anyone billed these codes, if so what is was the outcome and what code did you use? are you billing the the 99050 - 99051 with regular office visit codes 99201 - 99205 or 99211 - 99215? Or are there other codes that can be used?

(this is for an orthopedic practice)


thank you in advance for your help
anna

 

[nyauco91787]

After Hours

Hi everybody,

I work in a pediatrics office and we will be starting to use CPT 99051, however, we are not sure if 99051 is enough or billing 99051 with 99202-99205/99212-99215 will be paid and if so what modifier should be used. Can someone please help me or guide me to the correct path? This is a new code for us and any little detail/information would help. Thank you

 

[mitchellde]

Codes 99050 and 99051 are additional codes and cannot veiled alone. They are not restricted to E&M services either so if you had an after hours encounter for say a lac repair only you might have just thecode for the lac repair plus the 99051 or 99050.