Pediatric Coding Alert

Question: Our 16-physician pediatric practice completes a lot of forms for parents. Is there a way to charge and get paid for these services?

Ohio Subscriber

Answer: Yes, there is a code with which to bill for the service you have provided: 99080 (special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form). This code clearly states that it should be used for special reports such as insurance forms. Normally, this code is used for lengthy insurance reports, such as those needed for life insurance or new health insurance.

It is highly doubtful that a managed care company would pay for completing school or camp forms. But it is not necessary to have a code to bill the parents directly for this service. You may want to charge a nominal fee to the parents for all forms. Just remember to keep the charge consistent to all parents and for all forms. You should notify parents ahead of time of your policy for such an item. If you are going to charge for the service make sure that the practice policy brochure contains this information.