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Thread: FMLA Paperwork

  1. #1

    Default FMLA Paperwork

    AAPC: Back to School
    If the patient comes into the office to have FMLA paperwork filled out, you would use CPT code(s) 99455 or 99456 with the ICD-9-CM code of V68.09, correct? What if the forms are completed the next day after the patient is seen? Would you use the same codes? Thanks.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  2. #2


    What does FMLA stand for?
    Nancy McGonigle

  3. #3


    Family Medical Leave Act.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default Was the patient actually examined?

    I couldn't tell from your original description ... was the patient actually examined and history taken ... were all the bullet points listed in CPT for 99455 met?

    If so, I would bill the 99455 on the date the patient was seen in the office and would not bill separately for completing the paperwork.

    Think of it this way ... patient comes in for consultation on an issue. Patient is examined,tests are performed, but doctor doesn't dictate the report back to requesting MD until the next day. You wouldn't charge separately for doing the report; it's part and parcel of the E/M service.

    And the descriptiion of 99455 in CPT even has as one of the necessary bullet points:
    * Completiong of necessary documentation/certificates and report.

    F Tessa Bartels, CPC-E/M

  5. #5


    Thanks. The patient was actully examined the day before.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

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