Reader Question:
After-Hours Coding
Published on Sat Dec 01, 2001
Question: A patient had to be taken into surgery late at night. According to the surgeon, there is a code or modifier to raise reimbursement ethically for the after-hours surgery. What is he referring to?
Illinois Subscriber
Answer: Code 99052 (services requested between 10:00 pm and 8:00 am in addition to basic service) can be reported in addition to the code(s) for the surgery. Unfortunately, many insurance carriers will not automatically offer additional reimbursement when this code is reported, and you will most likely need to appeal for additional compensation. For an orthopedic practice, this is an important point of contract negotiation with managed care carriers. Make sure the contract allows added compensation for emergency services rendered in the off hours of the morning and on weekends.
