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99080 Special Reports

  1. Default 99080 Special Reports
    Medical Coding Books
    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

  2. #2
    Location
    Sacramento
    Posts
    20
    Default 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.
    Debbie Kline, CPC, CMA
    Business Office Administrator
    North Valley Orthopedics
    Yuba City, CA

  3. Smile
    Quote Originally Posted by FREEPONY View Post
    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.

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