OMFS Update: 59 Codes Newly Billable

OMFS Update: 59 Codes Newly Billable

California’s Division of Workers’ Compensation (DWC) issued an update to the Physician and Non-Physician Practitioner portion of the Official Medical Fee Schedule (OMFS) for workers’ compensation, effective for dates of service on or after July 1.

Among the changes, 59 billing codes previously deemed “invalid” for reimbursement are now billable with reimbursement established ‘By Report’.

Newly Billable Procedure Codes

The DWC announced the update in a recent Newsline, and posted the order adopting the update on the Physician and Non-Physician Practitioner Fee Schedule page of the DWC website.

The order makes the codes listed below billable “by report.” Previously, the below codes were invalid:

Billing Code

Procedure

A9593

Gallium ga-68 psma-11 ucsf

A9594

Gallium ga-68 psma-11, ucla

D0606

Molecular test pub hlth path

D1701

Pfizer vacc admin 1st dose

D1702

Pfizer vacc admin 2nd dose

D1703

Moderna vacc admin 1st dose

D1704

Moderna vacc admin 2nd dose

D1705

AstraZeneca vacc adm 1st dos

D1706

AstraZeneca vacc adm 2nd dos

D1707

Janssen vaccine admin

G0327

Colon ca scrn;bld-bsd biomrk

J0224

Inj. lumasiran, 0.5 mg

J1951

Inj fensolvi 0.25 mg

J7168

Prothrombin complex kcentra

J9348

Inj. naxitamab-gqgk, 1 mg

J9353

Inj. margetuximab-cmkb, 5 mg

M0244

Casirivi and imdevi infus hm

M0245

Bamlan and etesev infusion

M0246

Bamlan and etesev infus home

Q0245

Bamlanivimab and etesevima

Q5123

Inj. riabni, 10 mg

0031A

Adm sarscov2 vac ad26 .5ml

0640T

Ncntc nr ifr spctrsc wnd

0641T

Ncntc nr ifr spctrsc wnd img

0642T

Ncntc nr ifr spctrsc wnd i&r

0643T

Tcat l ventr rstrj dev implt

0644T

Tcat rmvl/dblk icar mas perq

0645T

Tcat impltj c sins rdctj dev

0646T

Ttvi/rplcmt w/prstc vlv perq

0647T

Insj gtube perq mag gastrpxy

0648T

Quan mr alys tiss w/o mri

0649T

Quan mr alys tiss w/mri

0650T

Prgrmg dev eval scrms remote

0651T

Mag ctrld capsule endoscopy

0652T

Egd flx transnasal dx br/wa

0653T

Egd flx transnasal bx 1/mlt

0654T

Egd flx transnasal tube/cath

0655T

Tprnl focal abltj mal prst8

0656T

Vrt bdy tethering ant <7 seg

0657T

Vrt bdy tethering ant 8+ seg

0658T

Elec impd spectrsc 1+skn les

0659T

Tcat intra-c nfs supersat O2

0660T

Implt ant sgm io nbio rx sys

0661T

Rmvl&rimpltj ant sgm implt

0662T

Scalp cool 1st meas&calbrj

0663T

Scalp cool plmt mntr rmvl

0664T

Don hysterectomy open cdvr

0665T

Don hysterectomy open liv

0666T

Don hysterectomy laps liv

0667T

Don hysterectomy rcp uter

0668T

Bkbench prep don uter algrft

0669T

Bkbench rcnstj don uter ven

0670T

Bkbench rcnstj don uter artl

90626

Tic-brn enceph vac 0.25ml im

90627

Tic-brn enceph vac 0.5ml im

90671

Pcv15 vaccine im

90677

Pcv20 vaccine im

90758

Zaire ebolavirus vac live im

91303

Sarscov2 vac ad26 .5ml im

As always, we’ll keep our readers updated with any further updates to the OMFS.


We keep track of the OMFS so you don’t have to. Try our DaisyWizard OMFS Calculator free, and see how much easier workers’ comp billing can be.

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