Worker’s comp and new patients

September 1, 2006

In our state, when we see a worker’s compensation case, we are required to create a new chart just for that visit. When this occurs, can we charge a “new patient” code for the first time the patient is seen for a work-related problem? Also, if a patient has other problems unrelated to work, can we charge a separate E&M code for dealing with unrelated concerns?

Question: In our state, when we see a worker's compensation case, we are required to create a new chart just for that visit. When this occurs, can we charge a "new patient" code for the first time the patient is seen for a work-related problem? Also, if a patient has other problems unrelated to work, can we charge a separate E&M code for dealing with unrelated concerns?

Answer: Certainly you should check into your own state's laws, but according to coding and billing consultant and educator Bill Dacey, all worker's compensation visits are generally treated as new patient codes for each injury or accident. If you deal with other problems during the same visit, they should not be billed to worker's comp, but rather to other insurance the patient holds.