Evaluation & Management Services
Location-Based Adjustments (GPCIs) Now in Effect for California, as of January 1, 2019
Jan 30, 2019
Location-Based Adjustments (GPCIs) Now in Effect for California, as of January 1, 2019
For better or worse, location-based adjustments are here for California workers’ comp. Find out how they impact reimbursements in 2019. As our preliminary calculations...
CA OMFS: New Billing Codes for Physician Fee Schedule
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...
Denials/Reductions for Insufficient E/M Documentation Continue
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...
E/M Services Denied for Insufficient Documentation
May 30, 2018
E/M Services Denied for Insufficient Documentation
Increasingly, claims administrators are no longer downcoding evaluation and management (E/M) services. Instead, many claims administrators are denying charges for E/M service...
Reminder: E/M Reimbursements Higher in 2018
Feb 21, 2018
Reminder: E/M Reimbursements Higher in 2018
*Update: The 2021 OMFS updates drastically changed how E/M codes are billed.*Some of the most commonly used billing codes by our providers, Evaluation an...
5 Strategies to Prevent Denied Work Comp Bills
Nov 16, 2017
5 Strategies to Prevent Denied Work Comp Bills
California does not make it easy for work comp providers to get paid. The time and effort necessary to obtain proper reimbursement is an unfortunate reality of a system weigh...
Coding Clinic: How to Bill for Evaluation & Management Services
Nov 15, 2017
Coding Clinic: How to Bill for Evaluation & Management Services
As the Centers for Medicare and Medicaid Services (CMS) like to say, “If it is not documented, it has not been done.” Of course, documenting can be just as painstaking as the...