Wiki Workers Comp - Would they reimburse for Aftercare or Acute

[Erica Baird]

Does Worker Comp. requires the acute fx code to be used all the time when a claim is submitted. Per GL the aucte code is only for initial visits then it is Aftercare - but am told by physicians WC will not reimburse for afercare code on a claim- anyone has information on this - am in CA.

 

[armen]

Does Worker Comp. requires the acute fx code to be used all the time when a claim is submitted. Per GL the aucte code is only for initial visits then it is Aftercare - but am told by physicians WC will not reimburse for afercare code on a claim- anyone has information on this - am in CA.

The right thing to do is to bill acute Fx code on the initial visit and then aftercare V codes. If you have an approval from WC for treatment of fracture then I do not see why they would not reimburse afretcare, nobody expects fracture to heal after one visit. As far as I know WC always requires notes to be submitted with the claim form, they should be able to see that patient is following up for related problem. I would bill it the right way and if they deny try to appeal or get a letter from them asking you to bill acute Fx on all claims.