DWC Posts Fee Schedule Adjustments for Hospital Outpatient Departments/Ambulatory Surgical Centers

DWC's Latest Changes in Workers’ Comp Billing Legislation

DWC’s latest changes in workers’ comp billing legislation affect x-ray imaging services and clinical laboratory services

It is our passion to help physicians stay on top of the latest changes in workers’ comp billing legislation. If you have any questions about the changes to the Medicare payment system below, please feel free to call us–we’d love to talk to you. Who knows? It might be time for you to switch to an off-site medical billing service.

The Division of Workers’ Compensation (DWC) posted adjustments, effective March 15, 2018, to the hospital outpatient departments and ambulatory surgical centers section of the official medical fee schedule (OMFS) to conform to changes in the Medicare payment system as required by Labor Code section 5307.1.

These are the three main changes:

  • Recently added 42 C.F.R. section 419.71, Payment reduction for certain X-ray imaging services, became effective January 1, 2018. The OMFS adopts and incorporates by reference section 419.71, and related payment rules, addressing payment reduction for film X-ray imaging services and computed radiography imaging services.
  • Subdivision (a)(1) of section 9789.32 is corrected by deleting status indicator “Q4” from the table, for services rendered on or after December 15, 2016. Services assigned status indicator “Q4,” clinical laboratory services, are not considered a “supply, drug, device, blood product, or biological.” Thus, subdivision (a)(1) is not applicable to codes assigned status indicator “Q4.”
  • Composite APCs and comprehensive APCs payment rules are added and incorporated by reference by date of service. The adopted clarifying composite APCs and comprehensive APCs payment rules are declaratory of existing regulations.

If you need more information about the hospital outpatient departments and ambulatory surgical centers section of the OMFS, visit the DWC OMFS page.

Keeping up with the California Labor Codes can be extremely time-consuming, confusing, and costly for any physician’s practice. At MBC Systems, our staff are experts with new legislation application as well as the new fee schedules, bill review and independent bill review processes.

If you’re ready to experience fewer delays and denials and improved revenue, call us at 1-949-863-0022.