tci E/M Coding Alert - 2015 Issue 2

Reader Question: Try 99455 If No Other Plan Pays

Question: What code should I use to submit a claim for a disability exam that our physician performed? We are not able to provide this service under WC for this patient. Indiana Subscriber Answer: Since workers’ compensation (WC) won’t cover this service, you should submit 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; formulation of a diagnosis, assessment of capabilities and stability, and calculation of impairment; development of future medical treatment plan...

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