Eli's Rehab Report

Reader Question:

Disability Forms

Question: Is there a CPT code we can use when the physiatrist fills out disability or leave-of-absence forms? Sometimes they bring five or more papers for the physician to complete after their visit, but we don't know if we can bill for this time.

Oklahoma Subscriber

Answer: You can charge for filling out disability paperwork by billing 99080 (Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form) with the appropriate E/M office visit code. 99080 is an adjunct code, meaning you must report it in addition to another service. For example, a patient who performs heavy manual labor presents with carpal tunnel syndrome (354.0) and gives the physician disability paperwork to complete. The physiatrist evaluates the patient and spends 15 minutes filling out the forms.

Use your discretion when determining a charge for this service. Some physicians charge a nominal fee of $25-$30 every time they fill out disability forms. Others charge only when the amount of paperwork is burdensome. Many practices consider this a goodwill service that they perform for patients as a way of creating good relationships and believe that charging for it can cause hard feelings in the community.

Medicare doesn't cover 99080, and most other insurers reimburse for it only if the insurer specifically asked the physician to provide the information contained in the forms. If you are billing 99080, ask the patient to sign an advance beneficiary notice (ABN) ahead of time so she knows she will be responsible for paying for the service.

 

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