We often see patient outside of normal office hours for ocular emergencies and would bill a 99050 in addition to the E/M or 92xxx code. If an emergency patient comes in during regular hours with an emergency and a doctor has to attend to them immediately, due to the nature of the injury, we would bill a 99058 code in addition to the E/M or other CPT procedure code for the visit.

We’ve never had an insurer ever pay for those emergency visit codes. In order to receive payment for the emergent nature of the visit, how would you recommend that we handle that? I’ve read one article that stated that we should have the patient sign an ABN form and file the 99050 or 99058 with a GA modifier and bill the patient after the charge is denied which, as you can imagine would probably be difficult to collect from the patient once they left the office. However, since we are never paid for those two codes, would it be more advisable to have the patient sign an NEMB, or equivalent, form and collect that "emergency" fee at the time of visit?

Any advice or suggestions as to other ways to do this and be paid for the emergency services aspect of care welcome.

Tom Cheezum, O.D., CPC, COPC