Wiki Urgent Care E&M coding

MCHUBB

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So is anyone out there billing for afterhours urgent care? This would be for a clinic that is NOT opened for 24 hours, so would not be able to use emergency room level of service. So what codes would you use?
 
Mindy,
I do the coding for an after hours pediatric urgent care facility and we use the new and established patient office visit codes (9920x-9921x). Hope this info is helpful.

Linda Hallstrom, CPC, CEMC
Phoenix Arizona AAPC Chapter
2007-2010 Board of Directors, AAPC Chapter Association
480-202-3801
 
Thanks

thanks...... any and all help is appreciated. So anything other than a 24 hr .....seeing patients all the time....... than we use the regular codes used for office visits?... That is what I thought but wanted to make sure. Do you use the after hours codes, and if so do they get reimbursed?
 
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You can bill 99050, if after hours, in addition to your 992XX code. Yes, most private insurers pay them. Medicare does not.
 
99050 has a status indicator of "B". B=“Not payable, service part of another service performed on the same day”

http://www.cms.hhs.gov/PhysicianFeeSched/PFSRVF/list.asp?listpage=2

In the window, at the bottom, it states "View Items Per Page". Select your drop down key and select "all" and click *ALL*

Select the last 2009 file and open up the "download"

Select the spreed sheet listed as "PPRRVU09"

Scroll down to CPT code 99050- B (Bundled)
 
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