Urgent Walk-In 99058

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When reporting the code 99058 along with an E/M code 99214 would you modify both procdure codes? I modified only the first procedure code 99214 w/-25 and insurance paid the 99214 but denied the 99058. Has anyone had success with reporting the Urgent Walk-In code? Or, does it solely depend on the carrier?
 

ollielooya

True Blue
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Everett, WA
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WE've had minimal success with the carriers, some pay, some don't Surprinsingly some of the smaller insurance companies will pay. Your denials were probably deemed "bundling issues", correct? The Reimbursement we received was anywhere from $10.00 to $38.00, and usually I had to fight my way on appeals with those larger payers that said they would reimburse for the code. As a very wise coder once said, the amount of time,resources used to follow thru on follow-up and appeals is really not worth it. That being said, if your doctor has a practice which necessities the use of these codes, I would suggest that you negotiate in your payer contracts to have it included. MCR WILL NOT pay for this code.

BTW, I've spent a lot of time researching 99058.
---Suzanne E. Byrum
 
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Thank you Suzanne for your response. It was denied as a bundled procedure, and I anticipated that it would vary from carrier to carrier on reimbursement. I appreciate your feedback. Have a great day!
 
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