99051 -I have found the code

nc_coder

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We are a Family Practice office that has Saturday hours. I have found the code 99051 and am interested in using it. Does anyone else have experience with this code or know of a reason why I couldn't add it to the services we perform on Saturdays?
 

OCD_coder

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This code would have to be built into your contract to recieve payment as they are typically not paid by most payors. It would be for an internal tracking purpose only. MCR does not pay for them;

CMS-
Payment for covered services are always bundled into payment for other services not specified. There will be no RVUs or payment amounts for these codes and no separate payment is ever made. When these services are covered, payment for them is subsumed by the payment for the services to which they are incident.
 

nc_coder

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I have filed this code with services from the last 2 Saturdays. BCBS is the only one that I have received a response from yet. They allowed the charge as a separate service.
 

btadlock1

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We are a Family Practice office that has Saturday hours. I have found the code 99051 and am interested in using it. Does anyone else have experience with this code or know of a reason why I couldn't add it to the services we perform on Saturdays?

A lot of commercial payers pay it, but it varies by plan (and don't get me started on Aetna, if you bill an injection with it... (re: http://www.aapc.com/memberarea/forums/showthread.php?t=62890&highlight=aetna)
It's for use any time after regular business hours (after 5pm on weekdays, and on weekends)...it doesn't pay much, and it's hit or miss - UHC doesn't cover it, Aetna says they do, Cigna and BCBS depend on the group.
Medicare doesn't cover it, and usually, neither does Medicaid (*But, contact Medicaid about it - we have a contract provision with one of our Medicaid providers, that allows us to use 99050, in lieu of 99051).
Hope that helps! ;)
 
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99051 - regularly scheduled weekend, evening, holiday

It's for use any time after regular business hours (after 5pm on weekdays, and on weekends)...it doesn't pay much, and it's hit or miss - UHC doesn't cover it, Aetna says they do, Cigna and BCBS depend on the group.
Medicare doesn't cover it, and usually, neither does Medicaid (*But, contact Medicaid about it - we have a contract provision with one of our Medicaid providers, that allows us to use 99050, in lieu of 99051).
Hope that helps! ;)

99051 is for REGULARLY SCHEDULED evening, weekend and holiday hours. So if you are extending your hours of business to be open at those times, THIS is the appropriate code to use.

99050 is used when you provide services at times OTHER than your regularly scheduled business hours. So if the doctor meets the patient in the office at 7p even though the office is closed at that time, you would use 99050.

There are commercial carriers who will pay for this code, but our experience is that the vast majority of our claims are denied. (United HealthCare is the giant in our neck of the woods and UHC does not cover it.)

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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