Proper Use of HCPCS Code 99053

HCPCS Code 99053 is used by some providers as an extra charge for services rendered after 11 p.m. in a 24-hour facility. However, you should be aware that Code 99053 represents a TRICARE non-covered service and will be denied.

When the claim is denied, you will receive a denial code that indicates that Code 99053 has been improperly bundled with the primary code. This denial reason has led some providers to appeal the denial. However, the appeal process will uphold the denial based on the code being a non-covered service.

For further information, please call 1-888-TRIWEST (888-874-9378).