Questions for Dr. Stern

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91. I am trying to get correct coding for a client of ours who is an urgent
Care facility. My main question regards his facility side of his business, is he eligible and able to bill an e/m code on this side being the 99201-99215? He bills professional and facility charges we used to bill with a 99281-99285 and have discovered this is incorrect billing, are we able to bill 99201-99215 on the facility UB 04 side, his POS is 20. Please help as we are trying to fix this ASAP.

Yes, the correct codes for POS-20 are 99201-99215 on the facility UB 04 side.
However, if this is neither hospital-affiliated nor hospital-owned urgent care center, then billing on the UB 04 would NOT be appropriate. Even if it is hospital-affiliated, it may not meet the criteria. Read more at:

http://www.practicevelocity.com/urgent_care/coding/facility_code.php

Feel free to contact us with questions.

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David Stern, MD, CPC CEO, Practice Velocity Partner, Physicians Immediate Care Board Member, Urgent Care      Association of America Dr. Stern helped design the patent-pending Practice Velocity template (PiVoT) that is now used in over 240 urgent care centers. He is board certified in internal medicine and served as Chief Resident in Internal Medicine at Pennsylvania State University. Dr. Stern received his medical degree from Jefferson Medical College of Thomas Jefferson University after completing undergraduate studies at Houghton College in Houghton, NY. Dr. Stern serves on the Board of Directors of the Urgent Care Association of America (UCAOA). A Certified Professional Coder, Dr. Stern writes articles and presents at numerous national and regional conferences on topics, including medical charting, emr, medical coding and medical practice management. With additional partners of John Koehler, MD (CEO) and Terry Buzzard, MD (Regional Medical Director), they operate the urgent care consulting firm of National Med Network and the ten clinics (in Illinois and Oklahoma) of Physicians Immediate Care.

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