Workers’ compensation is insurance that benefits employees in the event of accidents or sickness at work. In the healthcare industry, worker’s compensation might cover diseases or injuries such as needlestick injuries, exposure to dangerous chemicals, or back disorders.
Benefits from workers’ compensation may include medical expenditures, lost earnings, rehabilitation fees, and payment for long-term disability. Claim filing can entail using CPT codes to determine medical billing and payments. Healthcare firms are frequently required to obtain worker’s compensation insurance for their employees.
According to the US Census Bureau, nearly 5 million occupational diseases or injuries result in workers’ Compensation claims yearly. Medical professionals must know the proper medical codes to utilize when an employee submits a claim to bill for services rendered.
This article will define some of workers’ Compensation’s most frequently used CPT codes. The purpose is to aid healthcare practitioners in accurately assigning billing codes to the treatment they offer injured workers.
Also Read: CPT Codes for Nephrology
List of the CPT codes for workers’ Compensation
99203 – office visit or another outpatient visit
An evaluation and management session with a new patient is held at the doctor’s office or during another outpatient appointment. Low-level medical decision-making occurs during the visit, and the clinician spends between 30 and 44 minutes overall on the interaction on a single occasion.
99455 – Review of Medical or Work-Related Disability
The doctor examines the patient for any health issues or work-related issues. He offers this service to both new and current patients, regardless of the location of the service.
99070 – Equipment and Supplies
When this happens, the doctor uses more supplies or equipment than they would typically during a visit to the patient. Medical gadgets, special trays, or medical supplies may be among these things, but eyeglasses or prescription glasses are not included.
97110 – Therapeutic Workouts
Physical therapy that uses specially created workouts and activities to improve patients’ mobility and fitness levels is known as a therapeutic exercise. It is typically applied to those with disabilities brought on by injuries. Still, it can also be used by people who are generally active and healthy to enhance their general health.
97530 – Physiotherapy Activities
This code applies to exercises and other non-exercise activities, like dynamic functional training exercises to help heal or work with wounded people. To enhance the patient’s functional performance while close to them, the doctor engages in various activities.
97535 – Self-care and household administration
When a patient is recovering from an acute illness, a healthcare provider must offer them the appropriate instructions.
97140 – Manual Treatment
Physical therapy, known as “manual therapy,” treats a variety of soft tissue and musculoskeletal diseases, such as chronic back pain, by carefully controlling the pressure and movement of the hands. Joint mobility, alignment, tissue healing, lymphatic drainage, and traction can all be improved with manual therapies.
90837 – Psychotherapy
This service involves the doctor treating the patient’s psychiatric illnesses with psychotherapy and various techniques. The average length of the treatment session is at least 53 minutes.
90791 – Psychiatric Assessment
In order to provide this service, the doctor evaluates the patient’s mental health for the purpose to make a diagnosis.
99072 – Various Medical Services
More than would typically be utilized or provided during an office visit or other non-facility encounter, the physician uses things, gives out materials, or needs clinical staff time. By lowering the possibility of spreading a respiratory-transmitted infectious disease that has resulted in a Public Health Emergency, these extra supplies, along with time, must support a secure in-person encounter.
99080 – Other Materials and Supplies
This code applies to the medical equipment and supplies required to complete the medical service associated with workers’ compensation treatment.
97542 – Utilizing a wheelchair
The doctor evaluates the patient’s requirement for a wheelchair and gives him wheelchair maneuvering instructions under this code.
97750 – Examinations of Physical Performance
The doctor looks at the patient’s physical abilities, such as their joint health and ability to do daily tasks through tests and everyday activities. The doctor completes a written report after evaluating the patient’s physical performance.
97112 – Neuromuscular Reeducation
Using clinical expertise and services, a doctor may administer neuromuscular reeducation as a therapeutic activity to lessen deficits and restore function. The limitations/deficiencies are anticipated to improve with the use of these techniques in a fair and generally predictable amount of time.
99214 – office visit or another outpatient visit
A doctor’s office visit or other outpatient appointment, including evaluation and management with a patient who has been a patient for some time, is scheduled. The physician spends 30-39 minutes on the contact, with moderate medical decision-making included in the visit.
99215 – office visit or another outpatient visit
This code is used whenever a patient who has been treated before receives a thorough examination and management service. The clinician spends between 40 and 54 minutes overall on the encounter during the visit, which requires significant medical decision-making.
Also Read: CPT Codes for General Surgery
99456 – Evaluation and Management of Complex Workers’ Compensation Cases
A work-related or medical disability examination, such as necessary for a workers’ compensation claim, is provided by a clinician other than the patient’s treating physician.
97533 – Techniques for integrating the senses
During this operation, the healthcare professional applies sensory integrative techniques to patients with documented sensory processing disorders, such as children with autism and brain traumas. By stimulating the client’s sensory system, this service aids in better information processing in the brain.
97537 – Reintegration Training in the Community or at Work
A patient receives individualized training for community employment reintegration during this technique. The training enables the sick or injured patient to rejoin the workforce and the community. For every 15 minutes the provider spends with the patient, use one unit of this code.
97010 – Cold or Hot Packs
The physician, such as a physical therapist, applies a hot or cold pack to a particular body spot to treat an illness or injury.
97012 – Machine Traction
Surgery can often be avoided with the use of mechanical traction. The methods used in mechanical traction depend on the condition, disease, level of tolerance, and spinal level that needs to be treated by the patient. A constant force or intermittent force can be used to apply traction.
Conclusion
For healthcare professionals who treat patients with workers’ Compensation, proper CPT code assignment is essential. Maintaining thorough medical records and accurately allocating CPT codes following the services rendered help to ensure appropriate billing and prompt reimbursement.
Healthcare providers must stay updated on industry rules and be knowledgeable of the numerous sorts of workers’ compensation claims they may encounter to use the correct CPT code for billing and care management. This enables companies to take care of the health issues of their workers while still adhering to their legal requirements and working to ensure their safety.