Eli's Rehab Report

Question: What code should I use when rating a patient at the completion of treatment when workers compensation insurance is involved?

Arizona Subscriber

Answer: If the rating is conducted by the patients treating physician, bill using 99455 (work-related or medical disability examination by the treating physician). This code requires that the treating physician complete a medical history and perform an examination commensurate with the patients condition; form a diagnosis, assessment of capabilities and stability, and calculation of the impairment; develop future medical treatment plans; and complete necessary documentation, certificates and report.

If the rating is conducted by a consulting physician, bill 99456 (work related or medical disability examination by other than the treating physician), which includes the same criteria as 99455.