Check If New Special Service Codes Apply to Your Practice
Published on Wed Jan 04, 2006
99051 reflects medicine's trend toward longer office hours
Your office always remains open evenings, so you can't use 99050. Right? Wrong. CPT 2006 opens the door to coding special services when a family physician has scheduled evening or Saturday hours, as well as when he provides late-night services at a 24-hour facility.
CPT 2006 has revamped the special services, procedures and reports subsection. -The new and revised codes give coders more options to describe the services their practice provides,- says Kim Kieke, CPC, a coding quality specialist at a multi-specialty clinic with over 60 family physicians in Austin, Texas. Changes include: Deletions:
- 99052--Services requested between 10:00 PM and 8:00 AM in addition to basic service
- 99054--Services requested on Sundays and holidays in addition to basic service. Additions:
- 99051--Service(s) provided in the office during regularly scheduled evening, weekend, or holiday office hours, in addition to basic service
- 99053--Service(s) provided between 10:00 PM and 8:00 AM at 24-hour facility, in addition to basic service
- 99060--Service(s) provided on an emergency basis, out of the office, which disrupts other scheduled office services, in addition to basic service. Revisions:
- 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
- 99056--Service(s) typically provided in the office, provided out of the office at request of patient, in addition to basic service
- 99058--Service(s) provided on an emergency basis in the office, which disrupts other scheduled office services, in addition to basic service.
Use 99051 for Posted Nontraditional Hours In the new year, you can also look forward to code 99051 to use for services provided during posted evening, weekend and holiday hours. -Some payers allowed coders to use 99050 when a clinic provided services outside traditional office hours,- Kieke says. Insurers sometimes understood the cost-saving benefit of treating a patient in an office-setting as opposed to the emergency department and applied 99050 more liberally.
CPT 2006's new code 99051, however, more appropriately describes the special service. -We never had a code to use for after traditional business hours,- Kieke says. In 2006, coders can use 99051.
How it works: A non-24-hour clinic is open evenings, Saturdays and holidays. When an FP provides an E/M service during these times, you should report new code 99051 for a service -provided in the office during regularly scheduled evening, weekend, or holiday office hours, in addition to basic service.-
For instance, a mother presents with a 16-month-old on a Saturday afternoon to a local clinic that is open 9 a.m. to 7 p.m. The child has a fever and a runny nose and is pulling on her ear. The FP performs a new patient office visit that [...]
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