tci General Surgery Coding Alert - 2004 Issue 11

Select 99455-99456 - Not E/Ms - for WC Evaluations

If your surgeon evaluates a patient for a workers' compensation claim, you should turn to codes 99455-99456 rather than E/M services such as outpatient consults (99241-99245) or office visits (99201-99215).  The surgeon most often performs a baseline for disability certification or to establish the patient's percentage of disability related to body injuries or disease. CPT allows two codes for this service:99455 - Work-related or medical disability examination by the treating physician that includes:   - completion of a medical history commensurate with the patient's condition;   - performance of an examination commensurate with the patient's condition  ...

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