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Urgent Care E&M coding

  1. Default Urgent Care E&M coding
    Medical Coding Books
    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

  2. #2
    Location
    Richardson, Texas
    Posts
    170
    Default
    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

  3. Default 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?
    Last edited by MCHUBB; 02-26-2009 at 03:50 PM.
    Mindy

  4. #4
    Default
    You can bill 99050, if after hours, in addition to your 992XX code. Yes, most private insurers pay them. Medicare does not.

  5. #5
    Location
    North Carolina
    Posts
    3,126
    Default
    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/PhysicianFeeS...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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