tci Medicare Compliance & Reimbursement - 2013 Issue 24

Reader Question: Check for Interruption Before Reporting 99058

Question: A mother called and reported her baby was having trouble breathing. A nurse recognized that the problem required emergent status and advised her to come in immediately. When the mother arrived, a nurse performed triage assessment. She determined the patient’s breathing was no longer an emergency clinical condition and scheduled an appointment for the baby in an open time slot two hours later. Can I use 99058 for the walk-in? Answer: No. If, during triage assessment, a nurse determines a patient’s clinical condition is not emergent and works the child into an open time slot, you...

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