California Workers' Comp
Sep 21, 2018
Med-Legal Misconceptions: 4 Ways NOT to Use Billing Code ML106
In California, physicians use code ML106 to bill for supplemental medical-legal examinations. However, what constitutes a supplemental medical-legal exam for billing purposes...
Sep 20, 2018
Maximus Blunders AGAIN with 99358 Decision and a Math Error
Maximus Federal Services, the entity responsible for conducting Independent Bill Review (IBR) on behalf of California’s Division of Workers’ Compensation (DWC), has once agai...
Sep 19, 2018
Time and Billable Units for CPT Codes 99358 and 99359
Changes have been made to the California OMFS since the publication of this article. Be sure to see the latest analyses here and here.2021 OMFS updates drastically cha...
%20rounded.png)
Sep 14, 2018
CA Providers: Do Not Alter Bill When Submitting Second Review Appeal
To appeal incorrect reimbursements or bill denials, California providers must submit timely and compliant requests for second review. To date, DaisyBill clients have recovere...
Sep 13, 2018
CA Drug Formulary Update Effective October 1
California’s Division of Workers’ Compensation (DWC) issued an update to Medical Treatment Utilization Schedule (MTUS) drug formulary, effective October 1, 2018. The formular...
Sep 12, 2018
CA Pharmaceutical Fee File Corrected
Providers, take note: California’s Division of Workers’ Compensation (DWC) announced that the Medi-Cal pharmaceutical fee data file, updated weekly, was replaced for the week...
Sep 10, 2018
CA: Location-Based Adjustments Set to Take Effect in 2019
In April, the California Division of Workers’ Compensation (DWC) held a hearing regarding the inclusion of the Medicare Geographic Practice Cost Indices (GPCI) in the Physici...
Sep 7, 2018
CA Claims Admins Fail to Comply With IBR Rules
When the Independent Bill Review (IBR) process overturns a claims administrator’s incorrect denial or adjustment, the claims administrator is legally bound to timely pay what...
%20rounded.png)
Sep 6, 2018
CA Pathology/Clinical Laboratory Billing: NCCI Edits Do Not Apply
Medicare’s National Correct Coding Initiative (NCCI) complicates California workers’ comp billing, to say the least. NCCI edits are the source of much confusion, as pr...
Aug 24, 2018
Broadspire Denies Unprocessed Workers’ Comp Bills
Broadspire, a global third-party claims administrator (TPA), incorrectly denied several bills for the treatment of an injured worker. While incorrect denials are nothing new ...
Aug 23, 2018
CA Workers' Comp: Navigating Billing for Allianz/FFIC
Effective May 1 of this year, insurers Allianz and Fireman’s Fund Insurance Company (FFIC) merged their payment systems for California workers’ comp to reflect Allianz’s 2015...
Aug 10, 2018
Maximus Creates IBR Delays With Impossible Demands
Maximus Federal Services, the private entity which conducts Independent Bill Review (IBR) on behalf of California’s Division of Workers’ Compensation (DWC), has always demons...