2024/2025 Membership Renewal is now open!

Follow-up visits in Emergency, UCC or AACC

Billing for follow-up care is divided into location-specific codes. Locations include a rotation-duty emergency department, AACC or UCC and a non-rotation-duty emergency department.

 

Criteria:

All of the following criteria must be met:

These codes apply to situations where a physician has examined the patient, and the patient is waiting for further evaluation, treatment and/or:

  • Waiting for a bed.
  • Transfer to another facility.
  • Requiring extended care

Rotation-duty emergency department criteria (03.05F, 03.05FA, 03.05FB):

  • May only be claimed by physicians on rotation duty or providing first-call coverage in an emergency department with more than 25,000 visits per year.
  • May not be claimed on the same shift by the physician who provided the initial assessment.
  • May not be claimed when the patient has been admitted to the hospital but is awaiting an inpatient bed.
  • May only be claimed once per patient per shift.

Follow up in a non rotation duty emergency department criteria (03.05FF, 03.05FG, 03.05FH):

  • May only be claimed by the physician who provided the initial assessment when a second call for attendance is made by staff or another physician.
  • May be claimed by another physician who is taking over the care of the patient.

Follow up in an AACC or UCC criteria (03.05FC, 03.05FD, 03.05FE):

  • May not be claimed on the same shift by the physician who provided the initial assessment.
  • May only be claimed once per patient per shift.
  • May only be claimed by physicians on rotation duty in an AACC or UCC. 

Additional information:

  • 03.05F, 03.05FA, 03.05FB, 03.05FC, 03.05FD, 03.05FE:
    • Rotation-duty ER department and AACC, UCC – These codes apply to situations where one physician has examined a patient, but (due to a shift change) a second physician needs to complete the service.
  • 03.05FF, 03.05FG, 03.05FH:
    • In non-rotation-duty departments, these codes apply to situations where the physician has examined the patient but has kept the patient in the emergency department for extended care.
    • The physician who initially assesses the patient must be called back to the emergency department on the patient’s behalf for a second attendance. In this case, a callback may not be claimed in addition (03.05FF, FG, FH apply).
    • May be claimed for assessment by physician taking care of or assuming care of the patient.