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99455, 99456 Help

  1. Default 99455, 99456 Help
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    We want to use the 99455, 99456 CPT codes for work related or medical disability examinations. We would like to know what other clinics are charging and what documentation are you require to bill these codes. We would appreciate any feedback you are willing to share.

  2. #2
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    Sioux Falls South Dakota
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    Quote Originally Posted by NURJAN View Post
    We want to use the 99455, 99456 CPT codes for work related or medical disability examinations. We would like to know what other clinics are charging and what documentation are you require to bill these codes. We would appreciate any feedback you are willing to share.
    Here is a good link as to what state uses which Impairment Rating Guide from the AMA: http://www.impairment.com/Use_of_AMA_Guides.htm

    The guides are a good source of what needs to be documented, also. In addition, your work comp carrier or medical disability offce will have their own forms that must be completed in their entirety.

    I can't share our fee, but it is based on two hours of work because of the exam, rating the disability/MMI, and all the paperwork. We do use dx code V68.01
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

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