OMFS
Oct 5, 2018
It's Official: GPCI Reimbursement Adjustments Coming to CA Workers' Comp
California’s Division of Workers’ Compensation (DWC) has pulled the trigger: Geographic Practice Cost Indices (GPCI) will take effect on January 1, 2019. GPCI will divide the...
Oct 4, 2018
CA OMFS Update: Outpatient/ASC Changes Effective October 1
California’s Division of Workers’ Compensation (DWC) ordered updates to the Hospital Outpatient and Ambulatory Surgical Center (ASC) portion of the Official Medical Fee Sched...
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 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...
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...
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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 3, 2018
CA DWC Revises OMFS Update, Resolves MUE/Acupuncture Confusion
A recently adopted Medicare Medically Unlikely Edit (MUE) assigned a value of “0” to many common workers’ comp billing codes, including those for acupuncture services. Provid...
Aug 1, 2018
OMFS Update: Reimbursement Change For Pathology and Clinical Laboratory Services
California’s Division of Workers’ Compensation (DWC) ordered an update to the Pathology and Clinical Laboratory section of the Official Medical Fee Schedule, bringing the OMF...
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, ...
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...