[Ohioaap-practicemanagers] 99051

[Jonathan Price]

Hi everyone,
    There is room for interpretation and hence variability by payer. The AAP’s 2017 Coding for Pediatrics p.168 indicates that CPT does not define evenings and holidays. It simply says that 99051 requires that the regularly scheduled office hours must be posted (this is also a requirement for 99050—the add on code for service in the office when the office would ordinarily be closed) and that the date and time of the service must be documented. By the way, the “outside of posted hours” 99050 code also requires documentation that the family requested to be seen outside of regular hrs. 
    As always, payers vary among themselves as to whether they pay for these codes, though it is clearly to their advantage if the alternative is for families to use an urgent care or ED.
        Jon
> On Jul 12, 2017, at 2:07 PM, Michael Chamberlin via Ohioaap-practicemanagers <ohioaap-practicemanagers at lists.deltaforce.net> wrote:
> 
> I have a question about when to use the 99051 code.  I had always believed that it was for appointments after 5 pm M-F and on the weekends.  In a recent AAP news "Coding Corner" article, it says for appointments after 6 pm and weekends.  The CPT book does not have a time for "evening" appointments.
> 
> Thoughts on this?  What is the definition?
> 
> Thanks in advance,
> 
> Mike
> 
> -- 
> Michael Chamberlin, M.D., FAAP
> Pediatric Assoc. of Mt Carmel
> 4371 Ferguson Dr
> Cincinnati, OH  45230
> 513-752-3650
> 513-752-3387 (fax)
> 
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