Primary Care Coding Alert

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: We recently began operating an after-hours walk-in clinic for urgent conditions. Would it be correct to charge 99050 (Services requested after office hours in addition to basic service) or 99058 (Office services provided on an emergency basis) in addition to whatever service is provided during the patient's visit? Kentucky Subscriber  

Answer: No, 99050 and 99058 were created to compensate a physician for the inconvenience involved in opening an office that had already been closed or for the time and expense of keeping an office open past regular office hours, either for the patient's convenience (99050) or because the patient had an emergency (99058). If, as in your case, you elect to have extended hours to accommodate walk-ins or urgent care, neither of these codes would apply. Your office is open regardless of the patient's emergency, and the patient is not requesting an after-hours service. You have chosen to offer the service. You are probably not giving up much by not using these codes. Medicare does not reimburse these codes, and few Medicaid carriers and commercial insurance companies do either.