Attention DEEOIC DME Providers - The Division of Energy Employees Occupational Illness Compensation (DEEOIC) has released new guidelines concerning the authorization of durable medical equipment (DME). For information about these new guidelines, please click here
The Division of Federal Employee’ Compensation Act (DFEC) has released new guidelines implementing service limitations for injection CPT codes 20550, 20551, 20552, 20553, and 20526, which goes into effect August 1, 2013.
CPT codes 20550 and 20551 will reimburse 4 encounters within a 12 month period with no additional encounters for the claimant after that year, and for the same case number.
CPT codes 20552 and 20553 will reimburse 10 encounters within a 12 month period with no additional encounters for the claimant after that year, and for the same case number.
CPT code 20526 will reimburse 3 injections within a 12 month period.
Effective 08/01/2013, The Office of Workers' Compensation (OWCP) will no longer utilize DOL homegrown procedure codes RP120, RP130 AND RP200 (Pain Management). When rendering Pain Management services, providers are to bill and/or submit for prior authorizations using the appropriate HCPCS/CPT codes applicable for the services. Request for prior authorizations for pain management services should include but not be limited to a complete and detailed treatment plan.
If you or someone you know has a medical condition not related to a workers' compensation injury or illness and doesn't have health insurance, or if you are a physician treating someone without health insurance, please click here
to learn about the new Health Insurance Marketplace created under the Affordable Care Act.