General Inquiry about billing...

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Lets say a patient comes into their doctors office, where they are currently a patient. They do not have an appointment, but they need urgent care because they are having difficulty breathing. They recieve allergy shots to help them breathe. My question is, "Can the doctors office now bill them as an urgent care patient?"
 

halebill

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Capital Coders, Columbia, SC
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From what I gather from this scenario, I would say NO. It's not the patient who would be "Urgent Care", but the provider/facility which would need to be credentialed as an Urgent Care. The patient is an established patient; are you their PCP? I would bill this encounter as place of service 11 (not 20). However, if the patient had to come in without an appointment, with an urgent or emergent matter which disrupted other scheduled office services, I would bill:

99058 Service/s provided on an emergency basis in the office, which disrupts other scheduled office services, in addition to the basic service

in addition to the appropriate E/M charge.


Bill Hale, CPC
 
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