MLFS Code(s)

ML200 - Missed Appointment for a Comprehensive or Follow-Up Medical-Legal Evaluation

MLFS Grade

F - Original Bill

Claims Administrator

Next Level Administrators

Bill Review Vendor

Genex

Employer

All Pest Pros Inc

Bill Processing Day Count

5 days to process bill from submission

EOR

Adjustment Reason

G3 - The Official Medical Fee Schedule does not list this code. No Payment is being made at this time. Please resubmit your claim with the OMFS code(s) that best describe the service(s) provided and your supporting documentation.

Second Review Reason to dispute incorrect reimbursement

Claims administrator incorrectly denied reimbursement. Per CCR §9795, ML200 is a valid code with a Relative Value of 31. Missed appointments are reimbursable when the injured worker fails to appear for the evaluation appointment. ML200 payment due: $503.75. In addition to payment, penalties and interest are now due.