tci ED Coding & Reimbursement Alert - 2007 Issue 9

Reader Questions: Use This Guidance for After-Hours Codes

Question: What's the deal with ED physicians getting paid for 99053? I know Medicare doesn't reimburse for it, but I-ve got some ED coder friends at other places who say they-re getting paid for it. Illinois Subscriber Answer: Special-services codes such as 99053(Service[s] provided between 10:00 PM and 8:00 AM at 24-hour facility, in addition to basic service)are popping up again, Caral Edelberg, CPC, CCS-P CHC, told attendees at the American Academy of Professional Coders (AAPC) National Conference in Seattle. "They were really big back in the dark ages, but people stopped using them because Medicare doesn't pay for...

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