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Questions for Dr. Stern

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24. I had been doing some research on the use of Code 99051 and then I opened the most recent Journal Of Urgent Care Medicine. The Q&A on "Additional Income" was very helpful. I do have a couple of questions concerning the use of Code 99051 that I am hoping you may be willing to help me with.

  • For evening hours, how does a payor know if a visit occurs at 7pm at night or 10 am in the morning? Do we have to somehow "time stamp" a claim?
  • I have heard that in our market certain payors will not reimburse for Code 99051 (specifically United/Medicare). Is it wrong to automatically not put Code 99051 on claims for those payors or should we consistently use of the code for all payors no matter what?
  • Our providers are struggling with the philosophical issue of adding additional cost to a visit when it is a deductible situation. They get the fact that it costs us more to operate in the evenings/weekends, but they struggle with passing more cost to the patient. Any thoughts?

Thank you for your questions. Here are my responses.

  • I have never seen a payor require this proof. However, the medical record should clearly document the time of service if it is ever contested.
  • You should never put this code on Medicare claims. It is fine to omit this code when this is agreed to between the UCC and the MCO.
  • Would they prefer to take a pay cut to make up for the additional costs? Maybe simply agreeing on a reasonable fee would make sense. Of course, you can not discriminate on the basis of whether the patient is in a deductible or not.

 

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David Stern, MD, CPC
CEO, Practice Velocity
Partner, Physicians Immediate Care
Board Member, Urgent Care      Association of America

Dr. Stern helped design the patent-pending Practice Velocity template (PiVoT) that is now used in over 240 urgent care centers. He is board certified in internal medicine and served as Chief Resident in Internal Medicine at Pennsylvania State University. Dr. Stern received his medical degree from Jefferson Medical College of Thomas Jefferson University after completing undergraduate studies at Houghton College in Houghton, NY. Dr. Stern serves on the Board of Directors of the Urgent Care Association of America (UCAOA). A Certified Professional Coder, Dr. Stern writes articles and presents at numerous national and regional conferences on topics, including medical charting, emr, medical coding and medical practice management. With additional partners of John Koehler, MD (CEO) and Terry Buzzard, MD (Regional Medical Director), they operate the urgent care consulting firm of National Med Network and the ten clinics (in Illinois and Oklahoma) of Physicians Immediate Care.

 

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