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clarifiy code 99051

  1. Question clarifiy code 99051
    Medical Coding Books
    Is anyone familiar with billing a 99051. I am understanding that this is an add on code for special services provided in addition to basic service. So does that mean it covers a physician completing special reports, etc in addition to the basic E&M code service?
    Thank you,
    Christine

  2. #2
    Location
    Kingsport, TN
    Posts
    149
    Default 99051
    In the Coders' Desk Reference for Procedures this code is described as,

    "This code is adjunct to basic services rendered. The physician reports this code to indicate services provided during posted evening, weekend, or holiday office hours in addition to basic services."

    It appears from this description that form completion, etc... would not be part of this service. Hope this helps.

  3. Default code 99051
    Okay, I quess my question is what services would be covered by this code. I'm not understanding the meaning of adjunct maybe?
    Thank you,
    Christine

  4. #4
    Location
    Kingsport, TN
    Posts
    149
    Default
    If what you need is a code to file for special reports, etc... you might try code 99080. But keep in mind this code is used only when the form(s) requires information beyond/more than the standard.

    Adjunct = http://www.google.com/search?hl=en&d...w&ved=0CAYQkAE

    Also, you might try searching this forum for other replies regarding these type of codes. I don't think it is a covered service with most insurances. Just do the search and see what you find.

    Good Luck!
    Last edited by kmhall; 07-08-2010 at 01:09 PM.

  5. #5
    Location
    Tucson Cactus Coders
    Posts
    5
    Wink
    I work in a large multi practice facility. When our patients are not able to see their primary provider. They need a same day appointment. We then schedule with our same day appointment clinic. This clinic stays open longer than our regullar hours. Patients who are seen after 5:00pm and on Sat. will be billed out with 99051 Scheduled after hours in addition to the regular office visit.
    Deborah Herreraherreradeb1@gmail.com

  6. Default
    Thank you very much. That is the explanation I was looking for.
    Thank you
    Christine

  7. Post 99051
    Our regural hours are Mon - Fri 8am- 9am no appointment necessary .Patients seen after 5pm should not be billed 99051 correct???????????

  8. Default 99051
    The services do not have to be outside of regularly scheduled hours. It just has to be after 5 Pm or on week-ends. It is just a "bonus" for being open at night or week-ends. Note that only a few insurances will consider this, and often patient is held responsible. In some cases, even a second copay is due....

  9. #9
    Location
    Columbia, MO
    Posts
    12,839
    Default
    The explanation I receive from most payers for denial of 99051 is that it is an elective patient decision to be seen at these times so they deferr it to patient responsibility. I have however received reimbursement from numerous payer for the other codes in this area the 99050, 99058, 99060, 99053. For the post with 8am to I am assuming 9PM hours, if you read the 99051 carefully it tells tou everything you need to know,; services provided in the office during REGULARLY SCHEDULED evening weekend and holiday hours. you sue this code inaddition to all other codes provided and yes you may need to charge the patient. But then it is a premium service to be able to come to the doctor after you get off work rather than go to the ER or take a day off from work, so there you go.

    Debra A. Mitchell, MSPH, CPC-H

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