Daniel, does that mean where you work - walk-ins are charged "more" than patients with an appointment?I use these codes over here in the practice I work for. It's for patients that walk in with no schedule appointment. You can use this during regular scheduled evening, weekend, or holiday office hours.
But I recommend you collect this money up front. Instead of billing the insurance for this. Meaning for example, patients pay like $15 to $25 extra outside of there co-pay, for seeing them on a walk in service. Because insurance companies aren't paying this to often. Don't get me wrong I seen payment on these. Anywhere from $5.00 to $20. So it depend on you how your practice would like to apply these codes.
Why would you want to use this code? I don't see any RVU's attached to the 99051. In my opinion I doubt very many insurances would reimburse separately for this code. Per CMS this would be bundled with payment for other services. (like the normal E/M). Most insurances are leaning towards following CMS guidelines. Where I work, walk-in's are coded/billed just like scheduled appointments, according to services provided and supporting documentation - why wouldn't they be? UNLESS it's an emergency. (that's a whole different thing) We're open till 6:00pm also. No special codes attached to any E/Ms, even for the walk in's.I bill for a family practice that's open 6am-10pm, 7 day per week.
When can I use the 99051? Can I use it after 5:30pm and on the weekends and holidays? How exactly does this code work?
Thanks for any advice!
The descrition given by Rebecca, is way off. Just looking at the CPT book, you can see this. This code is used for when a patient disrupts the physicians schedule. Like a patient seen on a walk in basis.
During regulary scheduled evening, weekend, or holiday office hours, in addition to basic services.
And about the other, respondent. Saying you can't collect the money up front for a walk in patient. Give me a source that tells me other wise. Why would this not be in compliance. You tell the patient up front when they come in, that they have to pay. $15.00 or $25.00 extra out of pocket, for seeing them on a walk in basis. Remember your providing a extra service for them.
Keep in mind, I still use this code 99051. But I recommend practices just collect this money up front.
I TOTALLY agree with Augustine here.You can not collect money up front for services such as 99051. You can also NOT charge extra for walk-ins over scheduled patients. This is ILLEGAL. You CAN however ask a patient to sign an advance beneficiary notice if you think their insurance will not pay for the services. This would hold them financially liable after the services are denied.
If you do charge extra in advance for the 99051, you would have to refund the money to the patient after insurance pays, as you are not legally able to charge the patient the difference between the allowed amount and the billed amount. So if the insurance pays 100%, there is no balance, and a refund must be issued. If an insurance company pays at 80% but has you adjust the balance to zero, stating patient responsibility zero, you still have to issue a refund. Also, if the insurance company states that the services are not billable (or what have you), and tell you to adjust to zero and issue no payment (and still state patient responsibility zero), you again would have to issue a refund to the patient.
The only kind of "extra" charges you are allowed to charge a patient for is for returned/bounced checks, and if your office has a no-show policy that results in a charge.