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Cpt 99051 -hours oncology clinic

  1. #1
    Question Cpt 99051 -hours oncology clinic
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    I hope someone can help verify if I am correct on my thoughts about this code. I know someone who is billing this code for an after hours oncology clinic. The patient came in to receive Neulasta only. Code 99051 was billed showing the status for the after hours clinic and then the 96372 and J2505 were billed for the service. A denial has come through for code 99051 and someone in my office feels that this code should receive a 25 modifier. I disagree as this code in not considered to be an E/M and therefore is not "seperately identifiable" to the service. This code (99051) only distinguishes the type of service (after hours). Does anyone agree with me? Thanks for any suggestions!

  2. #2
    Yes I agree. No modifier needed with 99051. Many insurance companies simply do not pay this code.

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