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What are some of the principal differences between reporting California medical transaction data and reporting requirements in other jurisdictions?

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What are some of the principal differences between reporting California medical transaction data and reporting requirements in other jurisdictions?

Question: 
What are some of the principal differences between reporting California medical transaction data and reporting requirements in other jurisdictions?
Answer: 

The principal differences related to reporting California medical transaction data include the following. Additional California-specific reporting requirements are listed in the California Medical Data Call Reporting Guide (Guide), Appendix 10A, California WCMED Reporting Requirements.

  • Medical Liens
    In California, the Paid Procedure Code for a lien must be reported with a California state-specific code. The codes to be used are consistent with the codes used to report liens to the Division of Workers' Compensation (DWC) via the Workers' Compensation Information System (WCIS). The state-specific medical lien code should always be reported in the Paid Procedure Code field. The Amount Charged by Provider reported should represent the amount that is in dispute for the lien and the Paid Amount should represent the settlement amount.

  • Medical Legal
    For medical legal services, the Paid Procedure Code must be reported with a California state-specific code along with the applicable modifier for the examiner type (Primary Treating Physician, Agreed Medical Examiner or Panel Qualified Medical Examiner) based on the California Medical Legal Fee Schedule. If an examination designation modifier (psych, toxicology, oncology) is applicable, it is also to be reported. Additionally, the Quantity/Number of Units per Procedure Code must be reported in minutes, not units, for the time-based medical legal codes and with 0000001 for medical legal codes for non-time based codes. Quantity Number of Units for additional records per code MLPRR shall be the number of additional pages beyond those included in the base examination code.

  • Copy Services
    Copy Services payable as medical must be reported with a California state-specific code. The Place of Service code reported should be the location of the medical records subpoenaed. In the event the record location is either the WCAB or another insurance company, Place of Service 99 should be reported.

For more detail with examples for each of the above requirements, refer to the Guide, Section 5, Paid Procedure Code.