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Emergency Visits in Office Setting

Selina Posted Wed 02nd of October, 2019 10:45:47 AM
Hi - How would you bill an emergency visit in the office? 99058 seems to say they came in and interrupted the doc's schedule (which is not the case). If the patient was referred by an emergency doc, is it billed as a 99241-99245 consult in the office? Her coverage requires it to be billed as emergency since she was out of area for her plan. (Labs and treatment for severe C-Diff) . Thank you!
SuperCoder Answered Thu 03rd of October, 2019 07:53:31 AM

There are two key words to remember when considering 99058 are emergency and interruption. If the patient arrives unexpectedly, has an emergency need, and other schedules are changed to accommodate the patient, the visit qualifies for 99058. If you had an opening in your schedule and other appointments were not impacted, do not report 99058. If patient was referred by another doctor for consultation, then code only from consultation office visit 99241-99245 as per documentation.


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