CPT coding: For ‘above and beyond' care, report 99050

Since pediatricians don't always see patients during regular office hours

, you may be left with a coding headache. If you are confused by the differences between 99050 and similar codes or do not think they are worth reporting, here are some real-world advice.

Watch the clock for 99050

While looking at after-hours codes, your first choice will often be 99050. Code 99050 comes into play when the doctor tends to the patient in the office during hours when the office would normally be closed.

For instance: Your practice normally closes at 4 pm on Wednesday; however the pediatrician tends to a patient at 6 pm visit along with the appropriate treatment codes.

Non-standard business hours could be 99051

If your practice has routine hours for seeing patients in the evenings or during holidays, do not forget about 99051.

For instance: Your office is open till 9 pm on Thursday evenings. A patient who comes at 7 pm is still within your posted office hours; however outside usual business hours. You need to explain the situation to your payer by including 99051 on the claim.

This rule changed some time back and people are confused by it. They do not understand that they can bill a 99051 any time it is after hours.

CPT does not clearly define after hours times', which adds to the confusion. When people enquire "When is after hours?", simply tell them it is when the insurance company stops answering the phone.

For CPT coding information and other CPT procedural guideline , sign up for a one-stop Medical Coding website.

CPT coding: For above and beyond' care, report 99050

By: James Smith

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