What code should I use for a workers' compensation examination?
CPT codes 99455 and 99456 are both designated to cover work-related or medical disability exams. The first covers an exam provided by the treating physician, and the second covers an exam provided by someone other than the treating physician.
According to CPT, both codes should be used to report “evaluations performed to establish baseline information,” when “no active management of the problem(s) is undertaken during the encounter.” If other evaluation and management (E/M) services or procedures are performed for the patient on the same date, you should also report the appropriate E/M or procedure code. Attaching a -25 modifier might help ensure that both services are reimbursed
http://www.aafp.org/fpm/2000/0100/p17.html
How does a physician report performing a Department of Transportation physical? With CPT® code 99455 and ICD-9 code V70.5, 99455 is for a work related or medical disability examination by the treating physician. (9945 is for this examination by other than the treating physician.) See the CPT® book for the complete description of the code.
It is incorrect to bill a preventive medicine code for this service, in the 99381-99397 series of codes. This service is not payable by the patient's insurance company, which does not cover employment related expenses. Billing with a preventive medicine service, and a general exam diagnosis code, V70.0, so that the insurance company pays the service, is incorrect
http://codapedia.com/~article_317_Department of Transportation DOT exams.cfm
99455 -- Disability examination
Q. When is it appropriate to bill CPT code 99455 -- work-related or medical disability examination? I have been told only on initial exam and release exam. Others have said every date of service, as long as the physician fills out the impairment (APS) rating.
A.
According to the AMA's CPT Assistant, these codes are used to create a "baseline" evaluation and do not involve management of any problems. Management of problems other than those related to the disability are reported using E&M codes (99201-99215) with a -25 modifier. If the physician is managing the work-related condition, then subsequent care is reported using the appropriate level of E&M code (99211-99215).
http://www.physicianspractice.com/coding/content/article/1462168/1589695
(CPT Assistant 95-emphasis added by me)