Urgent care is a go-to solution for treating common, non-life-threatening health problems. But did you know accurate coding is crucial for these services? If billing issues and claim denials are troubling you, understanding the most common urgent care CPT codes in 2024 can help. Let’s simplify things and dive into the codes used most often in urgent care centers.
What Makes Urgent Care Different from Emergency Care?
Urgent care and emergency care are not the same. Urgent care is for non-serious, time-sensitive health problems, while emergency care handles life-threatening issues.
Urgent care centers treat conditions like:
- Minor cuts
- Stomach pains
- Allergies
- Small burns
- Sprains
They also provide services like stitches, X-rays, flu shots, and lab tests. This makes urgent care clinics a convenient and affordable choice for many patients.
Most Common Urgent Care CPT Codes in 2024
CPT codes (Current Procedural Terminology) help healthcare providers bill accurately. Below is a list of the most common urgent care CPT codes in 2024, grouped by the type of service.
CPT Codes for New Patient Evaluation & Management (E/M)
- 99201–99205: These codes are for new patients and vary based on the time spent and complexity of the visit.
- 99202: A 15-minute visit for simple issues and decision-making.
- 99203: A 30-minute detailed examination with moderate complexity.
- 99204: A thorough 45-minute evaluation needing intermediate decisions.
- 99205: A detailed 60-minute consultation requiring complex decisions.
CPT Codes for Established Patient E/M Visits
- 99212–99215: These codes apply to follow-up visits with existing patients.
- 99212: A quick 10-minute check-up.
- 99213: A 20-minute visit with a basic evaluation.
- 99214: A 30-minute detailed consultation.
- 99215: A 40-minute comprehensive assessment.
CPT Codes for Wound Care
- 12001–12007: These codes cover simple wound repairs based on wound size.
- 12001: Repairs wounds up to 2.5 cm.
- 12002: Covers injuries between 2.6 and 7.5 cm.
- 12004: Handles 7.6 to 12.5 cm wounds.
- 12005: For injuries 12.6 to 20 cm in size.
- 12006: Treats larger wounds between 20.1 and 30 cm.
CPT Code for Minor Burns
- 16000: This code is used for treating first-degree burns. It includes cleaning and dressing the burn to prevent infection.
CPT Codes for Incision & Drainage (I&D)
- 10060: Used for draining small abscesses, boils, or cysts.
- 10140: For draining fluid buildup like hematomas or seromas under the skin.
CPT Codes for Splints & Casts
- 29125: For applying a rigid splint on a forearm fracture.
- 29515: For applying a short leg splint to stabilize injuries below the knee.
CPT Code for Immunizations
- 90657: Covers flu shots for children aged 6 to 35 months, protecting them from three flu strains.
Special HCPCS Codes for Urgent Care
HCPCS codes starting with “S” are unique to urgent care:
- S9083: Covers all services during a single urgent care visit under one flat fee.
- S9088: Bills for urgent care visits requiring higher reimbursements.
Why Accurate Coding Matters
Correct coding ensures you get paid for your services and avoid claim rejections. Understanding the most common urgent care CPT codes in 2024 helps you streamline billing and focus on patient care.
Need Help with Billing?
Managing urgent care billing can be tricky. At Urgent RCM, we specialize in medical billing for urgent care centers. Let us handle the complexities while you care for your patients.
📞 Call us now at +1 978-709-1991 for expert billing solutions!
