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99080 - Special Reports - Is anyone using this?

  1. #1
    Question 99080 - Special Reports - Is anyone using this?
    Clearnace Sale
    My office is wanting to start charging insurance companies for CPT 99080 (Special Reports) because of all the time spent on filling out forms above and beyond. Though I would love to see my docs get extra $ I believe this code falls into the billing rule "Just Because There's a Code, Doesn't Mean it's Reimburseable".

    Is anyone else attempting or have attempted to get insurance companies to pay for this code? If so, are you successful? Any tips?

    Grand Junction, CO

  2. #2
    Omaha, Nebraska
    Cindy - we are in the same dilemma. Paperwork for disability carriers and work comp carriers as well as meetings/visits with work comp nurse case managers. I have post out here as well. I would appreciate if you could share any answers with me. My Email address is or Have a great day!
    Carolyn Kohler, CPC
    Omaha, NE

  3. #3
    I've never tried to bill this code to an insurance, but I'd be very surprised if they pay for it. You can always bill the patient....
    Walker Bachman, CPC, CPPM

  4. #4
    Santa Rosa
    Default Use of 99080
    I do bill this code, but only to W/C carriers when doing a PR-4 form to release the patient as permanent and stationary and/or quantify their percentage of future medical need.

  5. #5
    Omaha, Nebraska
    BTW, I DID bounce this question off of a Work Comp adjuster that I have been working with - and he said that as an adjuster, he realizes that a nurse case manager wanting to meet with the doctor is or can be important - as the NCM is working on behalf of the carrier - he would have no problem paying the doc for the time spent - but, does not know of an appropriate code - and would rather simply receive an invoice for services provided. Our issue is - if we can't bill someone for the doc's time, we can't justify reserving an appointment time slot for the meeting - therefore, we've been scheduling these individuals at the end of the day after clinic has finished - which then basically a) takes the doc away from the necessary end of day activities (i.e. dictating, answering questions, phone calls) or b) is being held on his own time ... Work Comp and Disability Carriers are the biggest time consumers of them all!!! I feel for these patients - there are a lot of providers who refuse to see these individuals - so, I feel strongly that SOMEONE has to be willing to treat them - but dealing with the paper/meeting requirements is such a nightmare!!
    Carolyn Kohler, CPC
    Omaha, NE

  6. #6
    Default WC
    We bill this code all the time for all workers comp. cases. Initial we charge 8 pages (8 units) and 2 for follow up. more than 50% of the time we get paid.

  7. #7
    Smile 99080
    I work in an Internal Medicine practice and we, too, bill this code out to Work Comp Carriers and it gets paid without question. We also charge patients who come into the office to have FMLA, Disability Papers, etc filled out. They pay for the services up front then rec the paperwork.

    Happy Coding Everyone!

  8. #8
    Sioux Falls South Dakota
    Default 99080
    I coded for a Physical Medicine/Rehabilitation clinic, and we too used this all the time with the Work Comp cases; especially for their long, long forms! The base charge was $350/hour; but of course, they told the WC carriers about this up front.

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