Primary Care Coding Alert

Question: An attorney representing one of our patients recently requested that our physician provide an opinion regarding an automobile accident. Our doctor reviewed the chart and dictated a letter to the attorney. Would this be coded as medical testimony, or would he have had to be under oath for us to assign this code? If so, what other code would I report?

Iowa Subscriber

Answer: The first consideration in this instance should be whether an insurance carrier can be billed for this service. Typically, the physician would directly bill the attorney who requested the letter.

However, if the payer were to be billed, 99080 (special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form) would be the most appropriate code. This code provides a mechanism for family physicians to be reimbursed for communications more extensive than those typically required when treating a patient.

Code 99075 (medical testimony) is reserved for occasions when a physicians practice reports time spent providing testimony in the judicial system.