urgent care

[ewheeler]

I am confused: have been told that we should be billing 99051 in addition to the E/M level if a patient comes into the urgent care facility after 5:00. Regular business hours are until 8:00.
To me 99051 would be for only special reports, consultations, ect., Can someone clarify this code for me. I am a Radiology coder and urgent care is new to me.

[cubbiecatz]

99051 is billed in addition to the E&M. It has nothing to with reports or consultations. I don't have a CPT book with me right now but 99051 should state something like: billed in addition to basic services. You would bill the appropriate E&M and then 99051, no modifiers since it is an add on code.

[ewheeler]

Just to make things clear..99051 can be added for all patients that are seen at an urgent care facility after 5:00 and on week-ends, correct?

[cubbiecatz]

Originally Posted by ola123

Just to make things clear..99051 can be added for all patients that are seen at an urgent care facility after 5:00 and on week-ends, correct?

Yes. I will caution you though, a majority of the insurance companies will bundle it into the E&M code. We only have 3 insurance carriers that actually pay on it. Others do cover it but they put it to the patient's deductible.