California Workers' Comp
Oct 3, 2018
CA DWC Proposes Pharma Fee Schedule Changes, Seeks Public Comment
California’s Division of Workers’ Compensation (DWC) proposed significant changes to the Pharmaceutical Fee Schedule. The proposals would bring pharmaceutical reimbursement c...
Sep 27, 2018
CA OMFS: New Billing Codes for Physician Fee Schedule
California’s Division of Workers’ Compensation (DWC) ordered updates to the Physician and Non-Physician Practitioner portion of Official Medical Fee Schedule (OMFS), effectiv...
Sep 26, 2018
DWC Will Hold Meeting on Controversial Medical-Legal Rule Proposals
In May of this year, California’s Division of Workers’ Compensation (DWC) announced proposed changes to the state Medical-Legal Fee Schedule (MLFS), and welcomed public comme...
Sep 25, 2018
IBR Accountability: Claims Admins Fail to Pay Providers
California regulations mandate that when Independent Bill Review (IBR) overturns a claims administrator’s incorrect bill denial or adjustment and finds in favor of the provid...
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...
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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...