Worker's Compensation Billing Guide & Notes
In a TD case, a supplemental report is sent to the insurance carrier after 2 to 4 weeks of treatment of status info. TD ends when the physician tells the insurance carrier that the patient is able to return to work. Final report is submitted.
Authorization for treatment is required before rendering services for a WC case. When billing WC for initial visit, always check state regulations on how to bill physician services. Note: QMEs - Qualified Medical Evaluators for injured workers. AME - Agreed medical evaluator IME - Independent medical evaluator CPT - 99456 may be used for work-related evaluation by other physician Helpful Billing tips
Coding - Work Harding
Physical medicine/therapy CPT codes 97001 - 97542 Med Legal Codes
If Your SBR is DeniedWhen the dispute is solely about the amount of payment allowed, then the next step is filing an IBR. All other disputes regarding payment for medical-legal services require a Petition of Determination, along with an accompanying Declaration of Readiness to Proceed, filed with the WCAB.
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When billing WC for initial visit, always check state regulations on how to bill physician services.
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