The Division of Workers’ Compensation has posted three new orders adjusting the Official Medical Fee Schedule (OMFS) to conform to changes in the Medicare payment system as required by Labor Code section 5307.1.

The Physician and Non-Physician Practitioner Fee Schedule update order adopts the following Medicare changes:

— CMS Medicare National Physician Fee Schedule Relative Value File RVU19D October 1, 2019 quarterly update
— National Correct Coding Initiative Practitioner Procedure to Procedure (PTP) Edits October 1, 2019 quarterly update
— National Correct Coding Initiative Medically Unlikely Edits October 1, 2019 quarterly update (excluding MUE “0” value codes)
— CMS ZIP Code to Carrier Locality files October 1, 2019 quarterly update, for Geographic Practice Cost Index (GPCI) locality mapping

The Hospital Outpatient Departments and Ambulatory Surgical Centers fee schedule update order adopts the following Centers for Medicare & Medicaid Services (CMS) Medicare changes:

— The CMS Medicare Hospital Outpatient Prospective Payment System (OPPS) October 2019 Addendum A quarterly update
— The CMS Medicare OPPS October 2019 Addendum B quarterly update
— The CMS Ambulatory Surgical Center Payment System, October 2019 ASC Approved HCPCS Code and Payment Rates, Column A entitled
— HCPCS Code” of “Oct 2019 ASC AA” and Column A entitled “HCPCS Code” of “Oct 2019 ASC EE”
— Certain sections of the CMS Medicare OPPS October 2019 Integrated Outpatient Code Editor (I/OCE), IOCE Quarterly Data Files V20.3 quarterly update
— CMS October 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS), Change Request (CR) 11451 (August 30, 2019), Transmittal R4387CP

The pathology and clinical laboratory fee schedule update order adopts the following Medicare change:

— CY 2019 Q4 Release: Revised for October 2019 (19CLABQ4)

The orders adopting the OMFS adjustments is effective for services rendered on or after October 1, 2019 and can be found on the DWC website.