work comp

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    Question office visit with chronic pain management

    Hello, Our provider feels his office visits support a 99214 due to pain management with patients that are being treated with pain meds. The patient has a work comp approved claim. The provider documentation has ROS of 7 systems, pain assessment with location, rating, description of pain...
  2. A

    Question Workers Comp Non-covered Services

    I work for a group of Urologist. 51798 is not on the Workmans comp fee schedule and I cannot find an alternative code to cover service. Can we legally bill the patient for non-covered cpt codes/services ? Can you attach a link that explains rules for billing workmans comp and supports the...
  3. K

    billing L&I

    I really need some help. The urgent care clinic that I work for uses a national billing company. This company is billing all of our new L&I claims as new patients even if they are established patients with us. When I objected they took it to the person who is the head of their entire billing...
  4. A

    Modifier for 99080 billing TX Work comp SOMR

    Hello - Does anyone know where I can find a list of appropriate modifiers for Texas work comp. We filled out the DWC073 and DWC069 stating the patient could now return to work. We billed our E/M code as well as the 99080 but used modifier 73. SOMR has kicked it back for the procedure code...
  5. A

    Texas Work Comp Modifiers for 99080

    Hello - Does anyone know where I can find a list of appropriate modifiers for Texas work comp. We filled out the DWC073 and DWC069 stating the patient could now return to work. We billed our E/M code as well as the 99080 but used modifier 73. SOMR has kicked it back for the procedure code is...
  6. K

    car accident billing

    I had a patient come in to our urgent care today who wanted to be seen for injuries sustained in a car accident. She said she didn't intend to open a claim with her auto insurance and wanted us to bill her medical policy. I explained that we only accept cash payment for car accidents because...
  7. B

    Work Related Injuries going to private health insurance

    I'm hoping to get some information from my fellow coders. We see quite a few patients with work-related injuries (that are not work comp). Many do not inform their employers (in many cases to keep from taking a drug test) or are self-employed. I seem to remember something in my CPB certification...
  8. J

    California Work Comp Timely Filing

    We just took on a fairly large revenue recovery project (we are charging per hour). There is about 10% Work Comp. However, Work Comp is not our forte. We are getting a lot of denials for untimely submission for claims that were previously submitted (but never received?). I looked for the "laws"...
  9. D

    HCPCS Help needed!!

    I am looking for HCPCS codes for the following medications that our doctors dispense to the patients and we bill to their WC carriers. Ketoprofen / Orudis - 75mgs Prilosec / Omeprazole - 20mgs Paxil / Paroxetine - 10mgs and 20mgs Ibuprofen / Motrin - 600mgs & 800mgs Hydrocodone / Norco -...
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