Postal Service, civilian employees of the Department of Defense, members of the Peace Corps, employees of American Embassies and certain others. The OWCP Medical Fee Schedule applies to FECA, EEOIC and LHWCA a modified version is used for the FBLBA.įECA (20 CFR Part 10) provides benefits for work-related injuries sustained by federal employees, employees of the U.S. Department of Labor's Office of Workers' Compensation Programs (OWCP) administers workers’ compensation programs under four federal Acts: the Federal Employees' Compensation Act (FECA), the Longshore and Harbor Workers' Compensation Act (LHWCA), the Federal Black Lung Benefits Act (FBLBA), and the Energy Employees Occupational Illness Compensation Program Act (EEOIC). Such charges may be submitted again under the above-listed coding schemes. Department of Labor's OWCP Program-specific codesĬharges and fees for current services that are billed under codes not current on the above-listed coding schemes, or that are applicable only to state workers' compensation programs, will be denied. O Uniform Bill 04 (UB-04, CMS-1450, OWCP-04) Revenue Center Codes (for services and procedures where CPT/HCPCS or OWCP codes are not required) O The American Dental Association, Current Dental Terminology 2011-2012 ( CDT). Department of Health and Human Services, Centers for Medicare and Medicaid Services, Healthcare Common Procedure Coding System Level II, 2012 (HCPCS). O The American Medical Association, Current Procedural Terminology ( CPT, 2012 edition). Department of Labor's Office of Workers' Compensation Programs: The following coding schemes are valid for billing medical procedures, services, durable medical equipment, and supplies, under the U. *** American Dental Association, Current Dental Terminology 2011-2012 ** Centers for Medicare and Medicaid Services, Healthcare Common Procedure Coding System, 2012 Edition * American Medical Association, Current Procedural Terminology, 2012 Edition Listings of Modifier Level Tables with OWCP-designated fee schedule adjustment for each modifier are contained in the file fs12_mod_table.xls. UB-04 Revenue Center Codes (RCC) that require CPT/HCPCS/OWCP procedure codes are contained in the file named fs12rcc_req_cpt.xlsĪ listing of geographic practice cost indices by Metropolitan Statistical Area (MSA) names in alphabetic order is contained in the file fs12gpci-by-msa.xls.Ī listing of geographic practice cost indices by ZIP code is contained in the file fs12gpci-by-zip.xls Professional Services, Equipment, and SuppliesĬPT*, HCPCS**, CDT*** and OWCP codes, pay status codes, RVU values, conversion factors and short descriptions are contained in the file named fs12_code_rvu_cf.xls RJ Health Systems International, LLC is an independent third-party vendor that is solely responsible for its products and services.INSTRUCTIONS FOR CALCULATING THE MAXIMUM ALLOWABLE DOLLAR AMOUNT RC Claim Assist TM is a product of RJ Health Systems. RC Claim Assist TM Copyright 2021 RJ Health Systems International, LLC. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. BCBSNM makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. Availity provides administrative services to BCBSNM. CPT is a registered trademark of the AMA.Īvaility is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Be sure to include your name, direct contact information, Tax ID and/or billing NPI.ĬPT copyright 2021 American Medical Association (AMA). Questions?Įmail our Provider Education Consultants. For registration help, call Availity Client Services at 80.įor navigation help and other details, refer to the NDC Units Calculator Tool User Guide. You can sign up today at Availity, at no charge. You must be registered with Availity to access to the NDC Units Calculator tool on the Availity Portal. The NDC Units Calculator is accessible in the Blue Cross and Blue Shield of New Mexico (BCBSNM) branded Payer Spaces section via the Availity Portal. This tool (also known as RC Claim Assist TM) is hosted by RJ Health Systems, an independent third-party pharmaceutical specialty company. The NDC Units Calculator is a user-friendly online tool that allows providers to convert applicable classified or specified Healthcare Common Procedure Coding System (HCPCS) or Current Procedural Terminology (CPT ®) codes to NDC units.
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