Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Medical Emergency)
Extended/After-hours
Clinics
11-4
Blue Cross and Blue Shield of Minnesota (Blue Cross) does not
consider an extended/after-hours clinic to be an emergency
department. An emergency department is defined as an organized
hospital-based facility for the provision of unscheduled episodic
services to patients who present for immediate medical attention.
The facility must be available 24 hours a day.
Clinic-based urgent care services may be billed under the place of
service (POS) 20. The POS code 20 will apply office benefits to
the services if submitted. DO NOT bill a corresponding facility
claim with the revenue code 0456 if already billing for urgent care
on the professional claim (837P). This would be considered
duplicate billing. Hospital-based emergency room urgent care
should be billed on the 837I only with the revenue code 0456.
Codes S9083 (global fee urgent care centers) and S9088 (services
provided in an urgent care center) represent where the service was
rendered, not the service itself. Thus, they are not separately
covered and will be denied as part of the primary service (such as
an E/M).
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (03/23/12)