The codes that matter most in a concussion program aren't the ones covering the initial evaluation, most programs already capture those correctly. It's the codes covering ongoing cognitive assessment, symptom management visits, and coordination across the episode of care that get underused, because they require documentation most practices haven't built the habit of capturing consistently.
Payer variation is real and program specific. What a commercial payer reimburses for cognitive testing and what a workers' compensation or school athletics-adjacent payer reimburses can differ meaningfully, and a program built around a single payer assumption will underperform the moment its patient mix shifts.
Written by John M. Abrahams, MD — board-certified neurosurgeon, founder of New York Brain & Spine Surgery.
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