dballard2004
True Blue
I am having a disagreement with a provider on an audit regarding a worker's comp exam. The provider coded the exam using an office/outpatient E/M code from the 99212-99215 range. All we did was an exam on the patient in order to file the report with company. We assumed no care of the patient and did not treat the patient during the encounter. My question is, would we not use 99455/99456 instead since we did not assume care of the patient? If we had treated the patient during the encounter, then the E/M code from the 99212-99215 range would apply correct? I'm very confused here and I appreciate any guideance. Thanks.