DWC Order Adopts Medically Unlikely Edits Without Zero Values

The California Division of Workers’ Compensation on Monday posted changes to the Official Medical Fee Schedule to eliminate Medically Unlikely Edits that are listed with zero value codes to avoid confusion that might lead to inappropriate denials of care. The Centers for Medicare and Medicaid Services updated its Physician Fee Schedule, effective July 1, to value all of the procedure codes for acupuncture at zero. That reflects CMS policy because acupuncture is not covered by Medicare and Medicaid, but does not conform the state workers’ compensation low, which does cover acupunct...