Orthopedic Coding Alert

Question: Is there a CPT code we can use when the orthopedist fills out disability or leave-of-absence forms? Sometimes patients bring five or more papers for the physician to complete after their visit, but we don't know if we can bill for this time.

Oklahoma Subscriber

Answer: You can charge for filling out disability paperwork and track these charges using 99080 (Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form). 99080 is an adjunct code, meaning that you must report it in addition to another service. For example, a patient who performs heavy manual labor presents with two fractured wrists and gives the orthopedist disability paperwork to complete. The orthopedist evaluates the patient and spends 15 minutes filling out the forms. In addition to reporting the code for the E/M service rendered, the physician also reports 99080 for completion of the paperwork.

Use your discretion when determining a charge for this service. Some physicians charge a nominal fee of $10-30 every time they fill out disability forms. Others charge only when the amount of paperwork completed is burdensome. Many practices consider this a goodwill service that they perform for patients as a way of creating a good relationship, and they believe that charging for it can cause hard feelings in the community.

As is true with most of the codes in the Special Services, Procedures, and Reports series, insurance carriers rarely reimburse for CPT code 99080. If you do charge for the completion of forms, it is advisable to obtain payment at the time the forms are completed. Otherwise ask the patient to sign a statement of financial responsibility ahead of time so she knows she will be responsible for paying for the service.