New visit E&M codes for Worker's Comp

01051184

Networker
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To my understanding in Work Comp billing, we can bill new patient E & M codes each time a patient comes in for a new injury. This is even though we have seen them within 3 years. Lately we have been getting denials from one of the WC carriers. They want an established code used.
I was wondering if any of you have ran into that issue lately and how you handle it. We don't want to down code if we don't have to.
I am in Indiana where we have no strict guidelines set up by the WC Board.

Any advice?

Thanks
 

dobsonphillips

Contributor
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I have found out that most WC carriers follow Medicare guidelines when it comes to billing WC patient. So in saying that I see why they would want an established patient code instead of a new patient visit.
 

keevans

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In Ga, we have no problem getting paid new pt visit for new problem wcomp, somewhere it should be in your work comp booklets. I would call and tell them that the new pt visit is allowed and see where you get with it. keevans
 
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