Part B Insider - 2015 Issue 2
Reader Question: Try 99455 If No Other Plan Pays
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Article Overview
This premium article answers a billing and coding question about disability examinations when workers’ compensation is not the payer. It is aimed at coders, billers, and physician office staff who need to understand the general claim-submission context for these services and the distinction between the related evaluation codes discussed in the answer.
Why This Topic Matters
Disability exam billing can differ from routine office work, and payer coverage is often limited or inconsistent. Understanding the article helps readers recognize the general coding context for these services and why payer responsibility affects how they are handled.
What You Will Learn
- The billing context for a disability examination when workers’ compensation does not apply.
- How the article frames the distinction between the related evaluation services discussed in the answer.
- Why coverage and patient notification considerations matter for these types of forms and exams.
- How payer assumptions can affect whether these services are routinely reimbursed.
Who Should Read This
- Medical coders
- Medical billers
- Physician office staff
- Revenue cycle staff
- Compliance staff
Codes Discussed
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