Outpatient Facility Coding Alert - 2019 Issue 10
Reader Question: Don’t Schedule This Code for Late Patients
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Article Overview
This article answers a reader question about office after-hours billing in the context of an outpatient patient encounter. It explains the general setting in which the guidance applies, notes the relationship to an accompanying evaluation and management service, and discusses payer-specific handling at a high level. The piece is intended for coders, billers, and office staff who need to understand whether a late-arriving patient encounter falls within the scope of this office after-hours code.
Why This Topic Matters
Understanding the boundary between regular office hours and after-hours services helps practices avoid inappropriate reporting and better evaluate when an additional office service code may be relevant. The article also highlights that payer policy can affect whether the code is reimbursed.
What You Will Learn
- How the article frames office after-hours billing in an outpatient setting.
- What general circumstances are described as relevant to the office after-hours code.
- Why payer policy matters when considering whether an additional office service code may be paid.
- How a late patient arrival is discussed in relation to posted office hours.
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Front office staff
- Physician office administrators
Codes Discussed
Code Ranges Discussed
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