If you ignore coding for urgent care, you can not expect to be profitable and successful. You must code for urgent care services or you will not get paid for them.
You need expert coding targeted to the particular field of urgent care. Unique coding issues to an urgent care startup include:
• Knowing when to use an evaluation and management (E&M) code for a procedure
• Identifying the correct modifiers for an E&M code in order to get paid
• Successfully appealing when a payor denies payment for the E&M code
• Differentiating between an established patient and a new patient
• Understanding how and when the definitions differ from a primary care practice
• Recognizing when circumstances cause the definitions to vary for each payor
• Using an intermediate laceration repair code, when a layered repair has not been performed
• Coding for multiple procedures performed on the same visit
• Understanding how to receive credit for a complete history, when a complete history was not performed
• Understanding the CMS definition of body areas and organ systems for E/M coding
You can spend years studying coding, or you can work with an expert. As a certified professional coder, I have helped scores of urgent care center owners, billers, and coders navigate the complexity of urgent care coding. Simply fill out this form to ask me your urgent care coding questions.