Orthopedic Coding Alert

Question: Is it possible to bill for transcription costs for a workers compensation report? We bill 99080 for the report, but our doctor heard that he can bill 99199 per page for transcription costs for the report in addition.

Vermont Subscriber

Answer: Supplying workers compensation carriers with status reports is an administrative burden that most orthopedic practices could do without. But, it is often the cost of doing business with a particular carrier and must be accepted if your office wants to continue its relationship with the insurer. If your practice has a contractual relationship with the carrier, review the contract for specific requirements regarding what documentation you must provide. If you are contractually obligated to supply patient updates to case managers, claims adjusters and office staff, you will obviously continue doing so. If this is not addressed in your contract, however, take the matter up with either the carriers provider relations manager or medical director.

In situations when you do not have a contract with the carrier, you are obligated to abide by the workers compensation laws of your state. Review these to determine if there are any statutory regulations on documentation. In the absence of such regulations, you will need to negotiate a mutually agreeable compromise with the carrier(s). Obviously, you will want to be most accommodating to the insurers that direct many patients to your practice.