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code for Sunday office vsit

  1. Default code for Sunday office vsit
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    Are there any modifiers or CPT codes for the case of a concierge patient coming in the see the MD on a Sunday? (in addition to office visit codes or instead of for after hours/weekend hours)
    thank you

  2. #2
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    Hi,

    I have not seen any modifiers or add-on codes which would suggest a concierge type code for the scenario you are explaining. I would think you should use a regular E/M code as usual.
    "When you have exhausted all possibilities, remember this: You haven't!"
    -Thomas Edison

  3. #3
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    You cannot bill for the extras covered by the concierge membership fee. That's the whole purpose of paying a membership fee to cover the extra access the patient has to the provider.
    Last edited by CodingKing; 11-13-2018 at 07:34 PM.
    CRC (2018), CPC-P-A (2016), COC-A (2016), CPC-A (2015), PAHM (2010)
    Contract/Fee Specialist - Remote

    20 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

  4. #4
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    First yes there are additional codes for a weekend encounter. In the case of a concierge patient, you might could use it if the concierge agreement allows for the additional charge.
    99050 if you are normally closed on Sunday or 99051 if you are normally open on Sunday
    You use these codes in addition to the service provided whether that is an E&M or just a procedure or an E&M and a procedure.

    Debra A. Mitchell, MSPH, CPC-H

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