After Hours Code --> RE: Re: ER misuse

[Guest guest]

I'm horrible about using this code...there are often situations where I should have coded it, but haven't.

But perhaps adding on a $50 (or whatever) After Hours Code would make us feel better about seeing a patient after hours and the hassle of leaving the house to drive to the office.

Explain to the 55 year old lady -- I would be happy to see you in the office tonight, but there will be an after hours charge of $50 that may or may not be covered by insurance.

And if it is truly an emergency (since she wanted to be seen in the ER), then there will also be an ER charge of $X.

Emergencies in the office

Q: Is the correct use of 99058, "Office services provided on an emergency basis," to add it to the customary office visit codes (99201-99215)? Can an "after-hours" code also be used?

A: According to CPT, 99058, like the other codes in the range 99000 through 99090, represents "an adjunct to the basic services rendered," so it should be billed in addition to the code for the base service rendered, as you suggested. The after-hours codes also fall into this category. Nothing in CPT prohibits coding both an after-hours code (e.g., 99050) and 99058 in addition to an office visit in the case of an office visit involving services provided on an emergency basis after office hours.

We really don't charge for what we do like we should in many situations.

Locke, MD

-----Original Message-----From: [mailto: ] On Behalf Of pricklyfinger2007Sent: Saturday, January 19, 2008 9:31 PMTo: Subject: Re: ER misuseannie, why oh why do you spoil your patients?and who the hell takes care of you?g>> Has anybody ever fired a patient for ER misuse?>> >> I just got a faxed ER note. Married couple, 30-something. Bothmorbidly> obese with elevated BPs and glucose intolerance who fail follow my> recommendations, but then decide (without calling me at all) to beseen in> theERfor very trivial complaints (URI -- basically a common coldfrom the> notes, although the ER got the benefit of doing labs and CXRs onboth). And> this is the second time in 4 months that they have done this.>> >> I am inclined to dismiss them on principle.even with the specter ofP4P,> their behavior is socially reprehensible and just pisses me off('scuse my> French). I have never dismissed anyone for anything other than drug-seeking,> abusive behavior, or owing me more than $200 for more than a year,but these> two just have my blood boiling.>> >> And it's not like I don't offer access.I'm on my way to the officenow (8:20> on Saturday night) because a healthy 55 yr old lady just called andtold me> she has been sick for 2 days but decided RIGHT NOW that she has tobe seen> and if I don't want to come in, she will go to the ER.>> >> >> ARRRRGGGGHHHHH! And it's 8 degrees out there.>> Annie>