Wiki CA WORK COMP DOCUMENT FEE

bill2doc

Expert
Messages
455
Best answers
0
Hi, Would appreciate some help with regards to what we can bill CA Work Comp for documents. What has been your experience? Do you bill 99080 and if so for what rate? I've also seen and heard of 99358 and WC002. Any help would be appreciated with regards to what these codes mean. We send every w/c claim with medical notes and I'm not sure which code and at which rate to submit.

Thank you!
 
99080 is for Federal Work Comp, not California Work Comp

Read this for when to use WC001, WC002, WC003, etc.

If you cover all of the components of form PR2 in your medical notes, then keep sending the medical notes. Otherwise, you should complete a PR2. The website in that link if full of fantastic information - they fight bad work comp denials all the time.

Here is the state web page with forms.

CPT 99358 is for the first hour of non face-to-face prolonged services such as record review. It is not for any E&M service.
 
Hi Bill2Doc- There are more guidelines about when and how often to bill the PR-2, as well as other reports. The PR-2 rate is $11.91 per title 8, CCR §9789.19 . Some payers won't actually reimburse you unless you identify your charge as the PR-2 or use the form. I recommend you look at this link to the DWC for more details: https://www.dir.ca.gov/dwc/FAQ/RBRVS_Faqs.html#PhysicianReports

My specialty is Workers's Comp, if you have any other questions. Cathy V.
 
Top