Defining Documentation Requirements for Coding Quality Care in Workers’ Compensation

Every year, more than 1 million workplace injuries or illnesses occur in the U.S. that are severe enough to result in days lost from work. Injured workers require medical care and careful attention to factors that will help them recover their ability to work, but American medical practice focuses on disease diagnosis and treatment and pays little attention to functional ability. In the workers’ compensation arena, health care providers must address causation, functional impact, and return-to-work planning, issues that are not represented in the most widely used payment systems, which are based on codes and coding rules designed for primary care and other group practice settings. These coding rules fail to capture and incentivize the delivery of services that are critically important in the workers’ compensation arena, while reimbur
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