OMFS
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...
Jun 8, 2018
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...
Jun 1, 2018
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...
May 31, 2018
Institutional Billing: How to Find Your Conversion Factor
For institutional billing, identifying the correct conversion factor is key to saving time and billing accurately.The Hospital Outpatient Departments and Ambulatory Su...
May 16, 2018
FYI: Workers’ Comp Telemedicine Reimbursed at Facility Rates
In California and elsewhere, telemedicine isn’t just the future — it’s the present. Of course, this shift to increasingly virtual services means unique new wrinkles in the wo...
May 3, 2018
DWC Orders Changes to OMFS Pathology/Clinical Lab Fees
The DWC posted an update order bringing the Pathology and Clinical Laboratory section of the Official Medical Fee Schedule (OMFS) into line with Medicare.The order rem...
May 2, 2018
DME: Invoice Not Required for (Most) Durable Medical Equipment
Too often, we see claims administrators demand extraneous paperwork from providers, adding unnecessary friction to the workers’ comp billing and payment process. One example ...