Wiki 99058

veeramani14

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99058 is inclusive to office vistis my provider using this code, but we are not getting payment for this can anyone help me out.
 
I have been paid for this on appeal. You must show that the patient was not scheduled and was an emergency, I always point out in my appeal that the patient was seen at the inconvenience of other scheduled patients.
 
There was another thread concerning this code submitted not too long ago, and I agree with Deb. So submit with the notes for an appeal. Once again reimbursement is payer specific, some might pay, others might not. I have had much better luck with the smaller carriers and they'll process it thru for payment. However the larger carriers (even with those that clearly state in their policy that it is an accepted code for payment) may hedge and it's always a fight. At least it's been that way for us.

---Suzanne E. Byrum CPC
 
One thing i put in every appeal letter is the statement that says.... "If this is not a benefit you wish for this office to afford to your beneficiaries, then in the future when they have urgent/emergent needs we will send them on to the emergency room." I have alwys been paid on appeal.
 
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