Effective February 1, 2008 new code 1074M, AP response to VRC/Employer request about RTW

Replaces 1048M for communication with Vocational Counselors (VRC)

Team conference, office visit, telephone call, or online communication with a VRC or employer cannot be billed separately.

1074M pays a maximum of $29.18 per provider per worker per day.

Examples of when health care providers may bill 1074M for written responses to:

• VRC or employer requests for:
  • Concurrence with a performance based physical capacities evaluation (PBPCE).
  • Authorization for worker to participate in a PBPCE.
• VRC requests to review and respond to:
  • Job modification or pre-job accommodation.
  • Proposed work hardening program.
  • Plan for graduated, transitional, return-to-work.

The Insurer Activity Prescription Form (APF) Billing Code 1073M replaced the Billing Codes listed below. These Billing Codes will not be paid on or after the listed dates of service.

See ActivityRx.LNI.wa.gov for more information about the APF.

Date of service: November 15, 2007

• 1039M, Time Loss Notification.
• 1056M, Supplemental Medical Report.
• 1026M, Physician's Final Report.

Date of service: February 1, 2008

• 1037M, Physical Capacity Evaluation (PCE).
• 1048M, Doctor's Estimate of Physical Capacities.