High returns with 19950 fee code
The WCB’s fee code 19950 for return-to-work consultation is a win-win-win-win according to Tsawwassen family physician Dr Martin Ray. That’s because up to four parties benefit when the return-to-work strategy is used. They include:
• The injured worker, who returns quickly and safely to meaningful work, monitored by the family physician.
• The employer, who has the employee back at the workplace performing functional activities.
• The family physician, who gets the opportunity to help the patient and to get paid by the WCB.
• The WCB, which can reduce the time the injured worker might otherwise be away from the workplace.
Dr Ray provides the 19950 return-to-work consultation to an average of one patient per month. “My direct involvement with the employer creates more opportunities for earlier return to work that is more job-related and ultimately, greater success in return to full duties,” says Dr Ray. “The risk for long-term disability goes down because the injured worker is back with his peer group at his workplace sooner, doing work that is associated with his normal duties.”
“I am continually amazed by employers’ willingness to accommodate injured workers,” he continues. “I ask my patients for the name and telephone number of their immediate supervisor. I ask the supervisor about the kinds of work that are available, and I can tell the supervisor what the injured worker can and cannot do. I’m specific about the activities that my patient can safely do. That relationship between the employer and the physician had been missing in the past.”
Good strategy, underutilized
Fee code 19950, which must include examination of the patient, consultation with the employer, and a follow-up return-to-work discussion with the injured worker, was introduced in 2000. Since then, although use of the fee code has increased steadily to 268 cases in 2004, fundamentally the return-to-work strategy and fee code, worth $260 per billing, are not being used to advantage by physicians who, Dr Ray feels, are well compensated for their time and effort.
No to stuffing envelopes
Dr Ray illustrates the ease of using fee code 19950 with an example of an injured construction laborer who works for a small construction company. “I called directly to the foreman on the job to discuss on-site duties that were appropriate for my patient,” says Dr Ray. “Sometimes I talk to the physiotherapist as well and integrate the rehabilitation program with graduated return to work. I said no to the injured laborer working in the office stuffing envelopes. I wanted my patient to stay on-site, maintaining physical activity and fitness and contact with the construction team. In this case, the patient was able to assist the carpenter for 4 to 6 weeks until he could return to full duties.”
RTW coordinators are waiting for your call
In larger companies, a coordinator and perhaps even an entire department are available to help physicians develop a formal plan to assist injured workers in returning safely to the workplace. For example, when a patient who worked as a butcher’s assistant in a major supermarket was injured, Dr Ray says he liaised with the coordinator of the company’s return-to-work program. “I usually speak to my patient’s immediate supervisor as well to discuss the availability of appropriate work,” he says. “The return-to-work coordinators are waiting for your call and they’re in tune with early return to work.”
How to use 19950
If you intend to use the 19950 strategy and fee code, please provide details in the clinical information section on your Form 11. If you have any questions about this fee code or require assistance, please contact the medical advisor in your nearest WCB office.
—Don Graham, MD
WCB Chief Medical Officer
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