Eli's Rehab Report

Question: In your July issue, you recommended using CPT 99080 (Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form) when the physiatrist fills out disability forms. Couldn't 99450-99456 also be used for this?

Oregon Subscriber

Answer: According to CPT, 99450 (Basic life and/or disability examination) should be used when the physiatrist performs a baseline evaluation prior to the issuance of life or disability insurance certificates. Codes 99455-99456 refer to work-related or medical disability evaluations, normally requested by workers' compensation or automobile insurers and billed directly to them. If the physiatrist performs this type of evaluation and fills out forms related to the exam, these codes should be billed instead of 99080 because these evaluations include filling out paperwork and it cannot be billed separately.

If the patient presents to the physiatrist for a different reason (such as a series of injections) and subsequently asks the physiatrist to fill out disability forms, the physiatrist cannot bill 99450-99456. He should bill for the service performed (in this case, the injections) in addition to 99080 for the form completion.