General Practice BILLING GUIDE - British Columbia Medical ...

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B WORKSAFEBC GP FEES B. WORKSAFEBC GP FEES Almost all workers in BC are covered under the Workers Compensation Act. WorkSafeBC provides coverage for the treatment of injuries and diseases that it has accepted as work caused. As such, medical services provided to injured workers covered and accepted under the Act are not insured by the Medical Services Plan. Working with physicians and employers in the community, WorkSafeBC’s goal is to facilitate a safe, timely, and durable return to work for injured workers. Prolonged absences from the workplace often result in de-conditioning, a reduced likelihood of recovery, increased pressure on family and personal relationships and a loss of selfesteem, as well as costly uses of health care and social services. The issue of causation is important to WorkSafeBC as the Act refers to personal injury, disease or death “arising out of and in the course of employment”. To be considered work-related, there must be a fifty-percent (50%) or greater probability that a condition arose out of work. It is not sufficient that it is “possible” that the condition arose out of work. The BCMA recognizes the physicians’ role in rehabilitating injured workers and assisting WorkSafeBC in returning them to work. To this end, where reasonable, the physician will advise workers that a safe and timely return to work may hasten their recovery. The concept of “hurt vs. harm” is important in occupational medicine. It is not possible to provide a specific diagnosis in every case. It may, however, be possible to exclude serious or progressive conditions that may be worsened by work. WorkSafeBC Fee Items These fees cannot be correctly interpreted without reference to the WorkSafeBC Guide to Fees. Fee Code Description WCB Fee Value April 01, 2007 19937 Form 8 – Report of First Injury, received by WorkSafeBC $42.84 within three business days of date of service and transmitted electronically. Paid in addition to office visit. 19338 Form 8 – Report of First Injury, received by WorkSafeBC $31.20 between four to six business days of date of service and submitted electronically. Paid in addition to office visit. Submission received after six business days will not be paid. GENERAL PRACTICE BILLING GUIDE B/1
B WORKSAFEBC GP FEES Fee Code Description WCB Fee Value April 01, 2007 19900 Form 8 – Report of First Injury, received by WorkSafeBC $31.24 within three business days of date of service and submitted via fax transmission. Paid in addition to office visit. 19901 Form 8 – Report of First Injury, received by WorkSafeBC $20.00 between four to six business days of date of service and submitted via fax transmission. Paid in addition to office visit. Submission received after six business days will not be paid. 19927 First Report of Injury (Form 8) that is requested by $50.00 WorkSafeBC after the injured worker is seen where the form is not initially required (See Form 8 rules), received within 10 business days of the faxed or telephone request. Submissions received after 10 business days of request will not be paid. Fee code 19904 may not be billed in addition as this fee includes copying of any existing reports or chart notes from an injured worker’s file. 19939 WorkSafeBC Requested Physician’s First Report (E-Form 8) $50.00 billed by physician – received within 10 business days of request. 19940 Form 11 – Progress Report Physical Examination, received $38.00 within three business days of date of service by WorkSafeBC and transmitted electronically. Paid additional to visit. 19941 Form 11 – Progress Report Physical Examination, received $17.00 between four to six business days of date of service by WorkSafeBC and submitted electronically. Paid in addition to office visit. Submission received after six business days will not be paid. 19902 Form 11 – Progress Report Physical Examination, received $29.12 within three business days of date of service by WorkSafeBC and submitted via fax transmission. Paid in addition to office visit. 19903 Form 11 – Progress Report Physical Examination, received $14.00 between four to six business days of date of service by WorkSafeBC and submitted via fax transmission. Paid in addition to office visit. Submission received after six business days will not be paid. 19904 WorkSafeBC request for copy of a consultation, operative, $40.00 chart notes, or other existing report – first 20 pages, received by fax within three business days of request. Not to be paid in addition to other fee codes except 19906. 19905 WorkSafeBC requested copy of consultation, operative, $25.00 or other existing report – first five pages or less sent by mail. 19906 Continuation of 19904 – over 20 pages, additional per page. $1.20 B/2 GENERAL PRACTICE BILLING GUIDE
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CONTENTS 4. Prevention Fees A/39 El
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GENERAL PRACTICE BILLING GUIDE
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A GP SERVICES COMMITTEE INCENTIVES
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Page 17 and 18: A GP SERVICES COMMITTEE INCENTIVES
Page 67: A GP SERVICES COMMITTEE INCENTIVES
Page 71 and 72: B WORKSAFEBC GP FEES Fee Code Descr
Page 73 and 74: GENERAL PRACTICE BILLING GUIDE
Page 75 and 76: C UNINSURED SERVICES A00073 A Medic
Page 77 and 78: C UNINSURED SERVICES NOTE: Physicia
Page 79 and 80: GENERAL PRACTICE BILLING GUIDE
Page 81 and 82: APPENDIX i FORMS FOR THE GPSC INITI
Page 95 and 96: APPENDIX ii OTHER TOOLS TO SUPPORT
Page 105 and 106: APPENDIX iii DIAGNOSTIC CODES QUICK
Page 107: APPENDIX iii DIAGNOSTIC CODES QUICK
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