California Workers' Comp
Jul 25, 2018
Denials/Reductions for Insufficient E/M Documentation Continue
We recently warned providers about an emerging trend among California workers’ comp claims administrators: denying payment for Evaluation and Management (E/M) services in the...
Jul 16, 2018
CA DWC Seeks Public Comment on MTUS Updates
California’s Division of Workers’ Compensation seeks to update the state’s Medical Treatment Utilization Schedule (MTUS). The DWC wants to align the MTUS with recent and not-...
Jul 13, 2018
Qualifications, Schmualifications: CA Gov Appoints High School Classmate to WCAB
California Governor Jerry Brown recently appointed former chorus director Juan Pedro Gaffney to the Workers’ Compensation Appeals Board (WCAB).Gaffney was a classmate ...
Jul 12, 2018
RFA For Emergency Treatment in California Workers' Comp
First, let’s be clear that providers never have to wait for authorization before providing emergency treatment an acute medical condition. Never.However, the provider ...
Jul 12, 2018
Acupuncture Remains Payable for CA Work Comp, Despite MUE
The Centers for Medicare and Medicaid Services (CMS) recently released a Medically Unlikely Edit (MUE) designating acupuncture billing codes 97810 through 97814 non-payable, ...
Jul 11, 2018
Workers’ Comp Billing Tip: Use a Detailed Cover Sheet
California’s Division of Workers’ Compensation (DWC) has many strict requirements as to what constitutes a “complete” bill for the treatment of injured workers. But given the...
Jun 29, 2018
CA OMFS Update: Physician Services and DMEPOS
California’s Division of Workers’ Compensation (DWC) posted update orders to two sections of the Official Medical Fee Schedule (OMFS), both effective July 1, 2018. The...
Jun 27, 2018
CA Providers: Appeal Denials for Treatment Preceding Liability Decision
Recently, we pointed out that California employers are liable for treatment that precedes the claims administrator’s decision to accept or deny a workers’ comp claim. Before ...
Jun 22, 2018
Conditional Authorization: How MPNs Cheat Workers’ Comp Providers
Medical Provider Networks (MPNs) are a drag on California workers’ compensation. Nominally designed to help employers control costs, MPNs rarely achieve more than throwing up...
Jun 21, 2018
Modifier 26 for Workers’ Comp Professional Services
Modifiers play a vital role in California workers’ compensation billing. But for all the value they add in allowing providers to more precisely specify the services rendered,...
Jun 20, 2018
Data Show MPNs Do Not Benefit Employers
Medical Provider Networks (MPNs) allow employers to limit where employees may seek treatment for work-related injuries. Theoretically, the purpose of MPNs is to direct care w...
Jun 15, 2018
Clearinghouses Under the Microscope: CorVel Corporation
Most claims administrators lack the technology to process electronic bills from providers. Instead, these claims administrators rely on clearinghouses. Since DaisyBill has di...