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ED Coding and Reimbursement Alert

Reader Questions:

After-Hours Code Not Always Reimbursed

Published on Sat Jul 15, 2006

Question: Is there any way to account for after-hours services that an ED physician provides?


Georgia Subscriber
Answer: There is an after-hours code on the books, but you-ll likely have a devil of a time getting some payers to recognize it.

When your ED physician provides after-hours services, it is possible to report 99053 (Service[s] provided between 10:00 p.m. and 8:00 a.m. at 24-hour facility, in addition to basic service).

Caveat: Medicare carriers will not reimburse for 99053. Private payers may accept 99053 -- if it is written into your contract. Reader Questions and You Be the Coder reviewed by Michael A. Granovsky, MD, CPC, FACEP, vice president of Medical Reimbursement Systems Inc., an ED coding and billing company in Stoneham, Mass.
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