August 31, 2017
Maximus Gets It Wrong in 99358 IBR Decision
Maximus Federal Services, the arbiter of Independent Bill Review (IBR) for the California Division of Workers’ Compensation (DWC), has denied payment to a provider due to an error on Maximus’ own part. The mistake, based on an outdated status code designation for CPT codes 99538 and 99359, is one DaisyBill anticipated. With Maximus behind the curve on changes to the Official Medical Fee Schedule (OMFS) effective this year, other providers may be in danger of the similar mistreatment.
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