tci ED Coding & Reimbursement Alert - 2003 Issue 3

Reader Question: For Some Payers,Special Services Apply to ED

Question: At a recent emergency medicine coding conference, I was encouraged to research special services codes 99052 and 99054 for future use on ED claims. I'm an experienced ED coder and have never used these codes, nor am I comfortable using them in addition to 99281-99285 (ED services), 99291 and 99292 (Critical care services). Should I be using these new service codes? Maryland SubscriberAnswer: Yes, you should look into reporting these special service codes for ED services. Codes 99052 (Services requested between 10:00 PM and 8:00 AM in addition to basic service) and 99054 (Services requested on Sundays and...

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