Orthopedic Coding Alert

Question: We-re working with a workers- compensation carrier that is having our physician view a video that shows the duties involved with the patient's job. Which CPT code could we use for this video viewing?

California Subscriber

Answer: Depending on your state workers- compensation regulations, you may be able to bill for the physician's time and also for any report he dictates that outlines his findings from the video.

The specific code will depend on the workers- compensation insurer's guidelines (which differ from state to state) and on whether the physician saw the patient that day.

For instance, if the physician evaluates the patient and then views the video afterward, you can report the appropriate E/M code (such as 99201-99215, Office visit ...) followed by +99358 (Prolonged evaluation and management service before and/or after direct [face-to-face] patient care ...) for the first hour of video viewing following the E/M service.

In addition, you-ll bill 99080 (Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form) for the report.

If in doubt, contact the carrier and let it know that a bill will be coming and ask for authorization prior to the physician viewing the video.

-- Reader Questions were reviewed by Heidi Stout, CPC, CCS-P, director of orthopedic coding services at The Coding Network LLC, and Bill Mallon, MD, orthopedic surgeon and medical director at Triangle Orthopedic Associates in Durham, NC.