Wiki Holiday office hours 99051

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cynthiar

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I have a pediatric practice that I work with, and they are asking if they can use the 99051 code with their basic services today (Martin Luther King Day), since today is a national holiday. They are open today and have regular hours.
We know that you can use 99050, if the office is closed and it is a holiday and we see a patient.

99051 states "services provided in the office during regularly schedule evening, weekend, or holiday office hours"

Thanks
C. Robinson
 
yes you may bill the 99051 for all scheduled visits today. A number of payers do not pay that code as they deem this to be elective decision on the patient's part to be seen on a holiday. If you did not inform the patients that there would be an additional charge for todays services then it might be bad form to bill it.
 
Not so fast

Debra, I would disagree. Martin Luther King's Birthday may be a recognized federal holiday, and most civil service entities (but not all) follow this guidelines. But the vast majority of businesses are open as per usual today.

I would use the code only for those holidays that are almost universally celebrated: New Year's Day, Memorial Day, 4th of July, Labor Day, Thanksgiving (maybe day after Thanksgiving), Christmas Eve, Christmas Day.

Another way to consider this is whether your practice will pay employees a premium for working on this holiday. If not, there is no reason to be charging the patients a premium.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
You guys need to keep talking because I'm hearing yes, it's okay, not it's not. Who uses it and who doesn't?

I can't use the practice of "do employees get a premium?" because that's not a policy here, even though we "used" to get today off as a holiday and now we don't.

I think it would be great as it is keeping people out of the emergency room. It's also allowing kids to be seen on a day where they don't have to miss school.
 
I have always followed the definition of holiday as defined by the the federal government if it is a holiday for them then it is a holiday, premium pay or not. most employers will use this as a floating holiday in lieu of premium pay. Today is a holiday by all definitions.
 
It is my understanding that you only use it for patients seen outside of normal business hours. If you have scheduled patients for that day because you were planning to be open, regardless of the holiday, then I would say no. If your office was planning to be closed that day and you got a call for an emergent situation and decided to open up for them, then you can bill it.
 
the 99051 is for visit that occur in the office on during SCHEDULED evening weekend and holiday office hours. Visits for hours when the office is closed is 99050
 
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