Results 1 to 4 of 4

99053 - The Dr that I bill for trying to

  1. #1
    Question 99053 - The Dr that I bill for trying to
    Medical Coding Books
    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....

  2. #2
    Milwaukee WI
    Default 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
    Last edited by FTessaBartels; 10-05-2009 at 01:04 PM.

  3. #3
    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.


  4. #4
    Columbia, MO
    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.

    Debra A. Mitchell, MSPH, CPC-H

Similar Threads

  1. 99053 - Can anyone tell me if it is appropriate
    By Melissa K in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 07-16-2013, 09:46 AM
  2. Code 99053
    By kbriscoe in forum Auditing General Discussion
    Replies: 0
    Last Post: 08-17-2011, 01:28 PM
  3. Billing for 99053
    By meganbruce in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 06-08-2011, 01:32 PM
  4. Should I be using a 99053?
    By lbellomy13 in forum Emergency Department
    Replies: 3
    Last Post: 12-23-2010, 01:43 AM
  5. Cpt 99053 - overnight for work
    By TinaG in forum Internal Medicine
    Replies: 2
    Last Post: 02-21-2008, 08:42 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.