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IME vs. Second Opinion

  1. Default IME vs. Second Opinion
    Medical Coding Books
    Hi everyone, I'm a new CPC-A working at an ortho office. We, of course, have many, many WC patients, voc rehab, etc. Our office manager has asked me to give a good definition of the differences between IME's and Second Opinions (and any mods) and how they would be charged. I know part of it is in the wording of the request and who makes the request, but wondered if any of you experts out there could give me more definite input?
    I would appreciate your help on this!
    Thanks so much,

  2. #2
    North Carolina
    Our practice also provides this service. This may vary from state to state but here's my view.

    Many of our IME's were provided for patients not affiliated with our practice. The WC carrier sends a truck load of medical notes for our surgeon to review. He, in turns, provides his expertise/recommendations for the continuing treatment of this patient. Our industrial commission has a set rate for this service.

    Code Time Fee
    IME 01 1 hour $100.00
    IME 02 2 hours $200.00
    IME 03 3 hours or more $400.00

    A second opinion is when the patient is sent to another provider and actually examined.

    This is my experience with our workers comp/occupational health services.
    Last edited by RebeccaWoodward*; 01-29-2009 at 09:11 AM.

  3. Default
    thanks so much Rebecca! If I'm not mistaken, I think you are in NC? I'm in NC, too, so this information is great to have!
    Thanks again,

  4. #4
    North Carolina
    I am indeed

    Happy Friday to you!

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