Orthopedic Coding Alert

E codes can get your claim paid faster. Although you have no national standards to follow regarding workers compensation claim coding, you can cut down on the headaches getting these claims paid can cause if you follow some universal diagnosis and evaluation coding guidelines. Myth #1: You Should Use 99455-99456 for E/M Visits Reality: If your orthopedic surgeon sees a workers compensation (WC) patient for an independent medical evaluation (IME) at the request of the patients employer or insurer, you should familiarize yourself with the WC E/M codes. To describe work-related or medical disability evaluations, CPT contains: " 99455 -- Work related or medical disability examination by the treating physician that includes: completion of a medical history commensurate with the patients condition; performance of an examination commensurate with the patients condition; formulation of a diagnosis, assessment of capabilities and stability, and calculation of impairment; development of future medical treatment plan; and [...]