99080 - Can you please give me a description/examples

jhack

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Can you please give me a description/examples of when this code can be billed. I have a Dr who bills this for filling out the FMLA paperwork. This initiates several angry patient calls and is being billed with a $25.00 charge. Any help is appreciated!!:)
 

RebeccaWoodward*

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This code is appropriate for completion of FMLA forms. I have also seen it used for completion of adoption forms. Your fee seems reasonable to me. After all, this is time the physician has to set aside in order to fill these out.
 

jhack

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Thanks-do you know of any resource that would have a listing of what is and isn't acceptable to use this code with? Also, does time spent completing forms play any role in using this make? (signing a release to work form and billing this is one example I have )
 

RebeccaWoodward*

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Are you referring to workers compensation when you state "signing a release to work form"? Workers comp varies from state to state and the billing aspect of it could vary. Is this for someone who has had surgery and they feel they are ready to return to work?

99080 is typically not recognized by insurance companies and therefore, selfpay. If you feel you are compliant, within the standards of your office, you should be fine. One thing I should mention...When we provide this service, we collect the fee at the time of service. The patient needs to be educated as to why this is an out of pocket expense. Most patients are williing to pay for these services if they are educated on why insurance companies deem this as a non-covered expense

Below is a Q/A from the AAFP

Q "Under what circumstances is it appropriate to submit 99080, "Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form?"

"Code 99080 is intended to be used when a physician fills out something other than a standard reporting form, such as paperwork related to the Family and Medical Leave Act. This code does not apply to the completion of routine forms, such as hospital-discharge summaries. Also note that it would not be appropriate to submit 99080 in conjunction with 99455 or 99456, which are the codes for work-related or medical disability evaluation services. The descriptors for these codes explicitly state that they include "completion of necessary documentation/certificates and reports."

Does this help?
 

ARCPC9491

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Totally agree w/ Rebecca.

My 2 cents worth:

If you decide to charge for forms, this should be set forth in your practice policy. We outline all of our policies, rx refills, appointments, forms completion, blah, blah, blah and have them sign and/or initial that they have read and understood each policy.

If this new to your policy, I would also post something in the waiting room that states "As of xx/xx/xxxx, we are now charging for forms completion because it takes us 35 minutes to fill them out"

(Just kidding about the last part, but that IS the reason why!!! LOL!!;) )

This helps prevents the angry patients, as they know in advance.
 
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