Wiki 99080 Special Reports

[jans04]

99254- Consult
99358- Evaluation and Management
99080- Special Reports

I know 99080 is inclusive to the office consult however, the phyiscian continues to put these codes on his superbills & so therefore we bill them. Our company insists on getting separate payment. Please give me your
input. Thank You

 

[FREEPONY]

consult reports

Hi
In reading your message I am assuming you are billing an inpatient consult for workers compensation. If it is in a facility then the report is included. If the visit took place in a non facility and was requested by another physician then the report is seperately reimbursable. This is documented in the workers compensation fee schedule. At least for California. Hope that helps.

 

[jans04]

Hi
In reading your message I am assuming you are billing an inpatient consult for workers compensation. If it is in a facility then the report is included. If the visit took place in a non facility and was requested by another physician then the report is seperately reimbursable. This is documented in the workers compensation fee schedule. At least for California. Hope that helps.

Thanks for confirming. I had just finished explaining this to the other biller, that (back in the day) this code was billable & separately payable if there was a Medical Legal Evaluation requested (work com of course) I remember because I did Work Comp billing a few years back in Los Angeles, CA and the fee schedule & billing concept are still the same. The client we are billing for is a PPO not work comp and the service took place in the facility on an outpatient basis. So I don't think we will be getting paid for this! Thanks again for your input.