Urgent care and ED billing is fast and high volume, where E/M level and add-on services decide payment.
Examples of frequently billed services, with billing notes from our coders.
| CPT code | Service | Billing note |
|---|---|---|
| 99284 | Emergency department visit, moderate complexity | Level supported by medical decision-making |
| 99213 | Office or urgent care visit, low to moderate | Check payer-specific urgent care rules |
| S9088 | Urgent care center service add-on (commercial payers) | Payer-specific code, not accepted by every plan |
| 12001 | Simple wound repair, 2.5 cm or less | Code by wound length and type |
| 87880 | Rapid strep antigen test | CLIA-waived test rules apply |
| 94640 | Breathing treatment (nebulizer) | Do not bill with certain other respiratory services |
| 73100 | X-ray of the wrist, two views | Professional vs technical split may apply |
Codes shown are common examples and descriptions are simplified in our own words. CPT® is a registered trademark of the American Medical Association. Always confirm against the current AMA CPT codebook, ICD-10-CM and each payer’s policy.
Modifiers tell the payer how and why a service was performed. Missing or wrong ones are a leading cause of denials.
Eligibility, benefits and prior authorization verified before the visit.
Code, modifier and documentation review before claims are submitted.
Denials corrected and appealed, aging claims worked until resolved.
Diagnostic testing, procedures and E/M claims coded correctly for each payer.
View billing detailsBiopsy, lesion removal and Mohs billing, with medical and cosmetic claims kept separate.
View billing detailsColonoscopy, endoscopy and screening claims coded for the right site and payer.
View billing detailsTalk to our team about your practice, hospital or lab. We will review your current billing and show you where revenue is slipping away.