Dynamic Chiropractic – June 6, 2006, Vol. 24, Issue 12

Billing for Sunday Visits and Out-of-Office Visits

By Samuel A. Collins

Q: I have a patient who suffered from a headache and neck pain over the weekend. He called my after-hours line and was subsequently seen on a Sunday. Is there any way of billing for treating a patient for an emergency Sunday visit?

A: There is a CPT code used to code a visit that occurs on a Sunday, when a Sunday is a day that the office is normally closed.

The code is 99050; it was revised in 2006. This code specifically is defined as "services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed (e.g., holidays, Saturday or Sunday), in addition to the basic service."

Therefore, for this visit you would code for the specific services done, such as examination, chiropractic spinal manipulation and any therapy, but you would additionally bill 99050 for the Sunday service. Note that most often, a "chiropractic emergency" visit is not one of a true emergency as defined in CPT, but a treatment wherein a patient is seen outside of regular hours. In this sense, to the treating chiropractor, it is of course an "emergency," but technically it is simply treatment outside of normal business hours or days, and would be coded as above.

Q: How do I bill for a patient visit that I performed at the patient's home?

A: To code for services done at a patient's home, the code is 99056. This code specifically is for "service(s) typically provided in the office, provided out of the office at request of the patient, in addition to the basic service."

Thus, for treating someone at his or her home, you would use the code 99056. The use of this code would be in addition to the specific services done, such as examination and treatment. Additionally, on the CMS 1500 billing form, in block 24B ("place of service"), you would indicate "12," which is the indicator for the patient's home.

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