Wiki 99053 - The Dr that I bill for trying to

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bschase

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The Dr that I bill for trying to bill a 99223 and a90053-25. I got a denial and I adv him of this denial. What I am trying to figure out is if the Dr seen a child at the hospital about pm on one day and the next day at 3am he seen the child again, What is the correct way to code and bill this?

Please Help....:confused:
 
99053 is an add-on code

You do not need any modifier on 99053 ... it is considered an add-on code. (I know, it doesn't have the + sign on it, but read the guidelines.)

However, VERY few payers will reimburse for this code. Check your contracts to determine whether you can bill to patient or must write-off.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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thanks Tessa

That is what I told the Dr's but they wanted me to try. Just wanted to try to see if others had the same thoughts.

Brenda
 
Your note sounds like there were two visits, but not the time of the first visit. If there were two visits and one was prior to Midnite and the other after midnite then you would bill for two visits with different dates of service. The 99053 is not for a different visit it is added on to the visit that occurred between 10pm and 8am. It is a way of charging a higher chaer charge for the same visit that would occur during normal hours. A lot of payers do not pay these But I have been better than 60% successful with appeal. It just sounds like you used it incorrectly.
 
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