OMFS

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...

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...

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...

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...

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...

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...

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...

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...

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, ...

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...

CorVel Error: Incorrectly Reimbursed ASC Services

CorVel Corporation, a national third-party administrator, incorrectly reimbursed multiple California workers’ comp providers for Ambulatory Surgical Center (ASC) services, at...

Multiple Payors Reimbursing WC002 at 2017 Rates

We’re halfway through 2018, and claims administrators are still reimbursing your office at 2017 rates for 2018 dates of service.We’ve noticed this problem all year for...