Oncology & Hematology Coding Alert

Reader Question:

No ICD-9 Code for Disability Evaluation

Question: My oncologist frequently treats patients on disability. How should I report the E/M services?

Idaho Subscriber Answer: CPT provides a specific series of service codes describing two types of disability: basic life and/or disability evaluation services (99450), and work-related or medical disability evaluation services (99455-99456).
 
The disability codes that are selected (from the codes listed above) represent the E/M of a patient to determine if the patient meets (or continues to meet) the requirements for being certified as "disabled." These services include a basic life insurance and/or disability exam (99450), work-related or medical disability exam by the treating physician (99455), and work-related or medical disability exam by other than the treating physician (99456).
 
Once your oncologist develops the treatment plan, you should report the ongoing care with the established patient codes (99211-99215). Periodically, the physician may have to "recertify" the patient's disabling condition. Bill this service with the disability codes, not the established patient codes.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Oncology & Hematology Coding Alert

View All