CALIFORNIA WORKERS COMPENSATION COLLECTIONS
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COLLECTIONS DISPUTES
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Medical-legal Listed By Objection and Link Opens The
Decisions  as to The Objections Listed
ML104  / ·Claims Administrator reimbursed $3,425.00 of
$9,637.540 with the following rational: “The charge exceeds the
Official Medical Fee Schedule allowance the charge has been adjusted
to the schedule allowance.”
ML-104-94 Claims administrator reimbursed $4875.00 for ML
104 indicating on the Explanation of Review “Modifier is not
appropriate with billed services
ML-104-94-95 Claims administrator reimbursed $937.50
indicating on the Explanation of Review “Based on the
documentation the following factors were met for determining the level
of reimbursement: R/R, combined R/R and F/F. causation however per
the ML FS the following are not considered factors or were not met:
apportionment.”
ML-104-95 Claims administrator denied ML 104-95 indicating on
the Explanation of Review “Complexity factors must be clear and
concise. Combined times are not appropriate. Please resubmit with
itemized and separate time factors for (Face-to-Face, Record Review,
Research).
ML-104-95-25 Claims administrator denied ML 104-95
indicating on the Explanation of Review “Significant,
separately identifiable evaluation and management service by the
same physician on the day of a procedure.”
ML-104 Claims administrator reimbursed $2000.00 for code ML
104 indicating on the Explanation of Review “The charge exceeds
the Official Medical Fee Schedule Allowance. The charge has been
adjusted to the scheduled allowance.”
ML-106-94 Claims administrator reduced fee reimbursement
indicating on the Explanation of Review “In accordance with the
California Official Medical Fee Schedule, section 9789.15.1, this
service was reduced due to the non-practitioner (NPP) –Payment
methodology (MNPR)”
ML104-94 Claims administrator reimbursement $4000.00
indicating on the Explanation of Review “Your bill has been
reduced based upon the recommendation of our review agency. If
you have a question concerning the reduction please contact Strata-
Care.”
ML-104-94Claims administrator reimbursed $4875.00 for ML
104 indicating on the Explanation of Review “Modifier is not
appropriate with billed services”
ML-104-95 As claims administrator does mention that report
preparation is not one of the complexity factors accepted as part
of reimbursement, and provider did not submit new documentation
to determine how much time was spent on medical record review,
only complexity factor 4- above may be used, not 5-.
ML-104-94No documentation was found in this review where
the provider is disputing the title Panel QME and therefore the
use of modifier -94 is inappropriate to be billed with ML 104.
ML 104 Claims administrator reimbursed code ML 104 in the
amount of $62.50 indicating on the Explanation of Review “The
charge for the procedure exceeds the amount indicated in the fee
schedule.
·ML 106 Claims Administrator reimbursed the Provider $240.00
of $500.00 in billed charges, with he following rational: “charge
exceeds Fee Schedule Allowance.”
ML101-93 Claims Administrator down coded ML 101 to ML 102
indicating on the Explanation of Review “reimbursement of code ML
101 is not recommended as the evaluation does not qualify as a
follow-up medical legal
ML101-94, 96100 EOR 11/19/2013 reflects reimbursement by
Claims Administrator in the amount of $168.24. Reimbursement
rational: “Amounts billed above the payment or the recommend
allowances as shown, are hereby objected to as being in excess of
amounts authorized under Labor Code.
ML101-93-94 Claims Administrator reimbursed $859.39
indicating on the Explanation of Review “The documentation
does not support the level of service billed. Reimbursement was
made for a code that is supported by the documentation submitted
with the billing.”
ML101-95 Provider is dissatisfied with reimbursement of ML
101
being reduced to ML 103 by Claims Administrator.
ML102 The Claims Administrator based reimbursement on  
99214, Established Patient Evaluation and WC004 Primary
Treating Physician Permanent and Stationary Report, as “more
appropriate.”
ML102-95 Claims Administrator reimbursed $162.00 of $625.00
with the following rational: “The Official Medical Fee Schedule
does not list this code. An allowance has been made for a comparable
service.”
ML102-94 Provider was reimbursed for the ML102, and denied
the additional 25% for the Modifier 94, Evaluation and
medical-legal testimony performed by an Agreed Medical Evaluator.
ML104-94 Claims Administrator denied entire billing of ML
104-94.·Based on the aforementioned documentation and guidelines,
additional reimbursement is indicated for ML 104-94
2016 New Publication
Medical Legal Process – Disputes –QME –
AME- PTP – Interpreters – Copy Services (with
Sample Pleadings and Petitions (Including 2nd
Review and IBR Samples)
Customized check lists offered for treatment, services, billing , payments and contested,  denied claims
Medications Medical Necessity Check List Based on
Thousands of IMRs
Services Medical Necessity Check List Based on
Thousands of IMRs
Billing and Payment Issues Check List Based on
Thousands of IBRS
Laws and  Procedure Issues
Check List
Post Termination
BURDEN OF PROOF
Evidence Used to Over Come
MPNs and Post Termination
Aquatic Therapy
Pain Management
Consultation
 
Functional capacity
evaluation
Spinal Cord Stimulator
Interdisciplinary pain
programs
Shoulder Arthroscopic
Subacromial Decompression
and Debridement
Click Below to Expand for instruction on how it
works (web)
(1) MPN BURDEN OF
PROVING
Surgery for rotator cuff
syndrome/Impingement
syndrome
Tens Units
Shockwave Treatment for the
cervical spine
PHYSICAL THERAPY FOR
CERVICAL AND LUMBAR
Chiropractic Post-Operative  
Therapy for the lumbar  
spine, (Fusion)
Medication Management
ISSUE MEDICAL -LEGAL:  
Can the primary treating
physician designate another
doctor to write a medical-legal
report
Diagnostic tests are Medical
Legal  Requested by Applicant's
P
TP  on the issue of industrial
causation
Part 1 Medical-Legal Expense
Disputes Not Subject to
Independent Bill Review
Norco  On Going
Management
Compound Medication (3)
Lidoderm patches
63650 –59 Percutaneous
implantation of
neurostimulator
63650 x 2
Copy Service Issue burden of
proof exempted from [Business
and Professions Code section
22450)
Medical-Legal Expense /
Disputes Part 1
Part 3 Medical-Legal
Petition Non-IBR
Medical-Legal / Defense  
Part 5 Medical-Legal
Disputes Petitions /
Waivers  
Part 6 Medical-Legal
Disputes Bad Faith    

Law Issues Charts Posted To Date

Saturday, December 19, 2015

2:36 PM

#10: Lien Issue  Just Because a Lien Activation Fee Is Paid, for Liens

#12: Lien Issue WCAB Rule 10866 (Cal. Code Regs., tit. 8, § 10866) requires that a compromise and release be served

#4: Lien Issue (1) Date Decided  WCJ erred in failing to find its lien timely

#8: Lien Issue  Continual  Medical Treatment

#9: Lien Issue  Filed Prior 2013 Tolling of The Statute of Limitations

(1) MPN BURDEN OF PROVING

Admitted Injury Denied Body Part

Authorization or No-Objection to PTP MPN is Not A Defense

Authorization Payment or partial payment consistent shall be retrospective approval

BURDEN OF PROOF Evidence Used to Over Come MPNs and Post Termination

Copy Service Issue burden of proof exempted from

[Business and Professions Code section 22450

Diagnostic tests are Medical Legal  Requested by Applicant's PTP  on the

issue of industrial causation

Diagnostic tests are Medical Legal  Requested by Applicant's PTP  on the issue of industrial causation

Interpreter Services Verification Rule 9795.3

ISSUE MEDICAL -LEGAL:  Can the primary treating physician designate another doctor to write a medical-legal report

ISSUE: ML-104 OR  ML-103 REDUCED ML102 COMPLEXITIES NOT ON FIRST PAGE

Labor Code § 4908.3

LACHES, DOCTRINE OF

Lien Issue  Burden of Proof

Lien Issue (1) Date Decided Nov 2014:Provider  provided services for future medical

Liens Filed Before January 01, 2013- Old Law Applies Labor Code: §4903.5

Liens Filed on or January 01, 2013- Labor Code §4903.5

Liens Not Required for Future Medical Treatment

Liens: Dismissed By Operation of Law Versus Dismissed With Prejudice  

Medical-Legal Expense / Disputes Part 1

Medical-Legal Expense / Disputes Part 2

MPN Defective Notices and Unreasonable Offer of Care

MPN ISSUE: FAILURE TO SEND PAPER AUTHORIZED T NEGATES TREATMENT IN MPN

MPN must have at least three  available primary treating physicians

MPN Transfer of Ongoing Care into the MPN.

MPN-Employee Required to Treat within 90 days to Accept or Reject Claim

MPN-Stipulation to NON-MPN Provider as PTP Is Consent for Treatment Outside MPN  

Non-Industrial Required to Treat Admitted Body Part   

Part #3 Medical-Legal Expense Disputes Petition filed by Defense or Provider

Part 1 Medical-Legal Expense Disputes Not Subject to Independent Bill Review

Part 1 Medical-Legal Expense Disputes Not Subject to Independent Bill Review

Part 2 Medical-Legal Expense Disputes Not Subject to Independent Bill Review

Part 2 Medical-Legal Expense Disputes Not Subject to Independent Bill Review

Part 3 Medical-Legal Petition Non-IBR Medical-Legal / Defense

Part 4 Medical-Legal Petition Non-IBR Medical-Legal / Provide

Part 5 Medical-Legal Disputes Petitions / Waiver

Part 6 Medical-Legal Disputes Bad Faith

Penalties and Interest: Petition to Enforce Independent Bill Review

Determination

Penalties and Interest: Petition to Enforce Independent Bill Review Determination

Post Termination

SANCTIONS AT THE WCAB FOR LIEN CLAIMANTS

 

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Above Newly Posted Charts 1282015
RESTORATION AFTERCARE
PROGRAM

Authorization Charts Posted to Date

Saturday, December 19, 2015

1:28 PM

Acupuncture

Acupuncture

Ambien

Aquatic Therapy

BUSPIRONE an anti-anxietymedication:

Chiropractic Post-Operative  Therapy for the lumbar

Chiropractic Post-Operative Therapy for the lumbar

COMPOUND MEDICATION - TRAMADOL CREAM 10

Consultation to Psychologist

Cyclobenzaprine

Diclofenac Sod

Doxepin

EMG upper extremity

EPIDURAL INJECTION

ESWT treatment of the elbow

Flexeril

Functional capacity evaluation

FUNCTIONAL RESTORATION

Gabapentin

Ibuprofen (Motrin)

Ibuprofen Cream

IMAGING (MRI)

IMPLANTABLE DRUG-DELIVERY

Inpatient detox

Interdisciplinary pain programs

Limbrel

lumbar spinal fusion

lumbar spinal fusion

Medication Management

Medication Management

Medrox ointment

Nabumetone (Relafen)

Naproxen (Naprosyn)

Naproxen Sodium-Anaprox -

Nizatidine ( Axid)

Norco  

Norco  On Going Management

Norco  On Going Management

OPIOIDS ON -GOING MANAGEMENT

Oxycodone

Pain Management Consultation

Pantoprazole DR (Prontonix)

Percocet, a short-acting opioid

PHYSICAL THERAPY FOR CERVICAL AND LUMBAR

PHYSICAL THERAPY FOR CERVICAL AND LUMBAR

Physical therapy for rotator cuff syndrome/Impingement  syndrome

Physical therapy for rotator cuff syndrome/Impingement syndrome

Post-operative physical therapy  for the (Fusion)

Post-operative physical therapy  for the (Fusion)

Ranitidine (Zantac )

Shockwave Treatment for the cervical spine

Shoulder Arthroscopic Subacromial Decompression and Debridement

Spinal Cord Stimulator

Surgery for rotator cuff syndrome/Impingement

RESTORATION AFTERCARE PROGRAM

Tens Units

Tens Units

Tramadol

TRIGGER POINT INJECTION

Tylenol-Codine

Valium

Venlafaxine (Effexor XR)

 

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Above Newly Posted Charts 1282015
ML104, Billed With FCE
Billing and Payments for Code
97750
Elavil Medication
Antidepressant
Bupropion  Medication
Antidepressant
CITALOPRAM   Medication
Antidepressant
Duloxetine   Medication
Antidepressant
Escitalopram    Medication
Antidepressant
Fluoxetine   Medication
Antidepressant
Milnacipran Medication
Antidepressant
Paroxetine  Medication
Antidepressant
Sertraline  Medication
Antidepressant
Venlafaxine  Medication
Antidepressant
Above Newly Posted Charts 010\2016
Labor Code 4903.5 Case Law:
Lien Claimant Without Filing
a Lien – Tolls The Time to File
Above Newly Posted Charts 010\2016
Untimely Independent
Medical review Still Valid Not
WCAB Issue
§9785. Reporting Duties of
the Primary Treating
Physician:
WC007-32 / When
Requested by Adjuster
63090–reported as 64999
22899, 64999, and 64999-59
97003 and 97140
90792  Psychiatric diagnostic
evaluation with medical
services

Medications Charted and Posted To Date

Saturday, December 19, 2015

1:06 PM

Ambien

Bupropion  Medication

Antidepressant

BUSPIRONE an anti-anxietymedication:

CITALOPRAM   Medication

Antidepressant

COMPOUND MEDICATION - TRAMADOL CREAM 10

Compound Medication (1) Retro compound TAD (tramadol, amitriptyline & diclofenac) cream

Compound Medication (2

Compound Medication (3)

Cyclobenzaprine

Diclofenac Sod

Doxepin

Duloxetine   Medication

Antidepressant

Elavil Medication

Antidepressant

Escitalopram    Medication

Antidepressant

Flexeril

Fluoxetine   Medication

Antidepressant

Gabapentin

Ibuprofen (Motrin)

Ibuprofen Cream

Lidoderm patches

Limbrel

Medrox ointment

Milnacipran Medication

Antidepressant

Nabumetone (Relafen)

Naproxen (Naprosyn)

Naproxen Sodium-Anaprox -

Nizatidine ( Axid)

Norco  

Norco  On Going Management

ODG (Compounds General) Topical analgesics

OPIOIDS ON -GOING MANAGEMENT

OPIOIDS ON –GOING MANAGEMENT

Oxycodone

Pantoprazole DR (Prontonix)

Paroxetine  Medication

Antidepressant

Percocet, a short-acting opioid

Ranitidine (Zantac )

Sertraline  Medication

Antidepressant

Tramadol

Tylenol-Codine

Valium

Venlafaxine  Medication

Antidepressant

Venlafaxine (Effexor XR)

 

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Payment Charting Issues to Date

Saturday, December 19, 2015

2:09 PM

# 4 Drug Screen Payments DOS 2013

§9785. Reporting Duties of

the Primary Treating

Physician:

22899, 64999, and 64999-59

62310 injection(s), of diagnostic or therapeutic substance

62311, Injection(s), of diagnostic or therapeutic substance(s) )

62311, Injection(s), of diagnostic or therapeutic substance(s) )

63090–reported as 64999

63650 –59 Percutaneous implantation of neurostimulator

63650 x 2

90792  Psychiatric diagnostic

evaluation with medical

services

96101 -Psychological testing Billing and Payments

96101 x 12 units, 96116 x 2

96101 x 7 / With ML-104

96101-59 DOS 2015

97003 and 97140

97813 and 97814 Acupuncture

97813 and 97814 Acupuncture

99205, 73560 -RT and 73560-LT Denial By UR Not a Defense

ASC G0260 -SG

ASC G0260 -SG

Billing Compound Medication

Code 97799-86 for date of service 11/03/2014

Code: G0477 Part (2) Calendar Year (CY) 2016 Clinical Laboratory Fee Schedule Drug Testing

Code: G0478 Part (3) Calendar Year (CY) 2016 Clinical Laboratory Fee Schedule Drug Testing

CPT 97750 -Physical performance test or measurement

CPT 97750 -Physical performance test or measurement

DME code E0478 Orthofix Cervical Stimulator

DRG 461

DRG 461

DRG 491Back & Neck Proc.Exc. spinal fusion W/O CC/MCC

DRG 974 (Exempt from Fee Schedule) 02/12/2015

E1399-LL

G0260 and G0260-50

G0260 and G0260-50

Medical-Legal as Consultation and Reports Claim adjudicated as non-compensable

Medical-Legal as Consultation and Reports, Claim adjudicated as non-compensable

ML 104 -Comprehensive

ML 106 billing: Report Writing  Payable

ML 106 billing: Report Writing Payable

ML-104 0 Initial Pay

ML-104 to 103-

ML-104 w/ Objection: Not a work related

ML-104-92 (by PTP)

ML104–94 and 96100 x 30 Units

WC: Drug Testing Calendar Year (CY) 2016 Clinical Laboratory Fee Schedule Drug Testing

WC002 and 99215 DOS 2015  Consent and No Objection as to PTP

WC004

WC007-32 / When

Requested by Adjuster

 

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ML 104 -Comprehensive
96101 -Psychological
testing Billing and
Payments
96101-59 DOS 2015
Billing Compound Medication
DRG 974 (Exempt from Fee
Schedule) 02/12/2015
Code 97799-86 for date of
service 11/03/2014 –11
/06/2014 Functional
Restoration Program
WC002 and 99215 DOS 2015
Consent and No Objection as
to PTP  Not A defense as No
Authorization or Treatment
Outside MPN
99205, 73560 -RT and
73560-LT
Denial By UR Not a Defense
DRG 491Back & Neck
Proc.Exc. spinal fusion W/O
CC/MCC
96101 x 7 / With ML-104
96101 x 12 units, 96116 x 2
WC004
E1399-LL
DME code E0478 Orthofix
Cervical Stimulator
# 1 Drug Screen Payments DOS
2013
# 2 Drug Screen Payments
DOS 2013
# 3 Drug Screen Payments
DOS 2014
# 4 Drug Screen Payments DOS
2013
62310 injection(s), of diagnostic
or therapeutic substance  
ML-104 w/ scroll feature
Objection: Not a work related
ML-104 to 103-w/ scroll feature
down coded ML104 to ML103
ML-104 0 Initial Pay-w/ scroll
feature
ML-104-92 (by PTP)
Down Coded to Office Visit
ML104–94 and 96100 x 30 Units
G0260 and G0260-50
Medical-Legal as
Consultation and Reports,
62311, Injection(s), of
diagnostic or therapeutic
ML 106 billing: Report
Writing Payable
CPT 97750 -Physical
performance test or
measurement
97813 and 97814
Acupuncture
DRG 461
ASC G0260 -SG
Code: G0477 Part (2) Calendar
Year (CY) 2016 Clinical
Laboratory Fee Schedule Drug
Testing
Code: G0478 Part (3)
Calendar Year (CY) 2016
Clinical Laboratory Fee
Schedule Drug Testing
Code: G0479 Part (4) Calendar
Year (CY) 2016 Clinical
Laboratory Fee Schedule Drug
Testing
Code: G0480 Part (5) Calendar
Year (CY) 2016 Clinical
Laboratory Fee Schedule Drug
Testing
Code: G0481 Part (6)
Calendar Year (CY) 2016
Clinical Laboratory Fee
Schedule Drug Testing
Code: G0482 Part (7)
Calendar Year (CY) 2016
Clinical Laboratory Fee
Schedule Drug Testing
Code: G0483 Part (8) Calendar
Year (CY) 2016 Clinical
Laboratory Fee Schedule Drug
Testing
Part (9) 2016 Clinical
Laboratory Fee Schedule
Drug Testing
Part (10) Other New and
Reconsidered Test Codes 2016
Clinical Laboratory Fee Schedule
Drug Testing
63650 –59 Percutaneous
implantation of
neurostimulator
63650 x 2
§9785. Reporting Duties of
the Primary Treating
Physician:
WC007-32 / When
Requested by Adjuster
ML104, Billed With FCE
Billing and Payments for Code
97750
63090–reported as 64999
22899, 64999, and 64999-59
97003 and 97140
90792  Psychiatric diagnostic
evaluation with medical
services
Post Termination
BURDEN OF PROOF
Evidence Used to Over Come
MPNs and Post Termination
Authorization or No-Objection
to PTP MPN is Not A Defense
MPN-Employee Required to
Treat within 90 days to Accept or
Reject Claim
Admitted Injury Denied
Body Part
Liens Filed on or January
01, 2013- Labor Code
§4903.5
Liens Filed Before January
01, 2013- Old Law Applies
Labor Code: §4903.5
Liens Not Required for
Future Medical Treatment
Labor Code § 4908.3
LACHES, DOCTRINE
OF –
Liens: Dismissed By
Operation of Law Versus
Dismissed With Prejudice  
MPN Transfer of Ongoing
Care into the MPN.
MPN Defective Notices and
Unreasonable Offer of Care  
MPN-Stipulation to NON-MPN
Provider as PTP Is Consent for
Treatment Outside MPN
 
Non-Industrial Required to
Treat Admitted Body Part   
Authorization Payment or
partial payment consistent
shall be retrospective approval
#4: Lien Issue (1) Date
Decided  WCJ erred in failing
to find its lien timely
#5: Lien Issue (1) Date
Decided Nov 2014:
Provider  provided services
for future medical
#6 : Lien Issue  Burden of
Proof
#8: Lien Issue  Continual
Medical Treatment
#9: Lien Issue  Filed Prior
2013"Tolling of The Statute of
Limitations"
#10: Lien Issue  Just Because a Lien
Activation Fee Is Paid, for Liens F
#12: Lien Issue
WCAB Rule 10866 (Cal. Code
Regs., tit. 8, § 10866) requires that a
compromise and release be served
(1) MPN BURDEN OF
PROVING
MPN ISSUE: FAILURE TO SEND
PAPER AUTHORIZED T
NEGATES TREATMENT IN MPN
MPN must have at least three
available primary treating
physicians
SANCTIONS AT THE WCAB
FOR LIEN CLAIMANTS
ISSUE: ML-104 OR  ML-103
REDUCED ML102 COMPLEXITIES
NOT ON FIRST PAGE
ISSUE MEDICAL -LEGAL:  Can the
primary treating physician designate
another doctor to write a
medical-legal report
Diagnostic tests are Medical Legal  
Requested by Applicant's P
TP  on the
issue of industrial causation
Penalties and Interest: Petition to
Enforce Independent Bill Review
Determination
Part 1 Medical-Legal Expense
Disputes Not Subject to
Independent Bill Review
Part 2 Medical-Legal Expense
Disputes Not Subject to
Independent Bill Review
Copy Service Issue burden of
proof exempted from
[Business and Professions
Code section 22450)
Interpreter Services
Verification Rule 9795.3
Medical-Legal Expense /
Disputes Part 1
Medical-Legal Expense /
Disputes Part 2
Part 3 Medical-Legal
Petition Non-IBR
Medical-Legal / Defense  
Part 4 Medical-Legal
Petition Non-IBR
Medical-Legal / Provider  
Part 5 Medical-Legal
Disputes Petitions / Waivers  
Part 6 Medical-Legal
Disputes Bad Faith    
Labor Code 4903.5 Case Law:
Lien Claimant Without Filing
a Lien – Tolls The Time to File
Untimely Independent
Medical review Still Valid Not
WCAB Issue
IMPLANTABLE DRUG-DELIVERY
EPIDURAL INJECTION
FUNCTIONAL RESTORATION
Aquatic Therapy
IMAGING (MRI)
TRIGGER POINT INJECTION
Pain Management Consultation  
Functional capacity
evaluation
ESWT treatment of the elbow
Spinal Cord Stimulator
Interdisciplinary pain programs
Shoulder Arthroscopic
Subacromial Decompression
and Debridement
EMG upper extremity
Inpatient detox
Consultation to Psychologist
Norco  On Going Management
Physical therapy for rotator
cuff syndrome/Impingement
syndrome
Surgery for rotator cuff
syndrome/Impingement
syndrome
Tens Units
Shockwave Treatment for the
cervical spine
Post-operative physical therapy  
for the (Fusion) lumbar spine  
PHYSICAL THERAPY FOR
CERVICAL AND LUMBAR
lumbar spinal fusion
Chiropractic Post-Operative  
Therapy for the lumbar  
spine, (Fusion)
Acupuncture
Medication Management
RESTORATION AFTERCARE
PROGRAM
Oxycodone
COMPOUND
MEDICATION -
TRAMADOL CREAM 10%
:
Ibuprofen Cream
Ibuprofen (Motrin)  
Naproxen (Naprosyn)
Naproxen
Sodium-Anaprox
--
Nizatidine ( Axid)
Diclofenac Sod
Ranitidine (Zantac )
Norco  
Nabumetone (Relafen)
Venlafaxine (Effexor
XR)
Cyclobenzaprine
Flexeril
Doxepin
Limbrel
Percocet,
a short-acting opioid
Tylenol-Codine
Gabapentin
Tramadol
Valium
BUSPIRONE an
anti-anxiety
medication:
Medrox ointment
OPIOIDS ON -GOING
MANAGEMENT
Ambien
Compound Medication (1)
Retro compound TAD
(tramadol, amitriptyline &
diclofenac) cream:
Norco  On Going
Management
Compound Medication (2)
Compound Medication (3)
Lidoderm patches
ODG (Compounds General)
Topical analgesics
Elavil Medication
Antidepressant
Bupropion  Medication
Antidepressant
CITALOPRAM   Medication
Antidepressant
Duloxetine   Medication
Antidepressant
Escitalopram    Medication
Antidepressant
Fluoxetine   Medication
Antidepressant
Milnacipran Medication
Antidepressant
Paroxetine  Medication
Antidepressant
Sertraline  Medication
Antidepressant
Venlafaxine  Medication
Antidepressant
Urine Drug Screen G6041,
G6045, and G6056
Urine Drug Screen G6041,
G6045, and G6056
Compound Medication NDC's
38779-0082-09 and
38779-0388-09
Compound Medication NDC's
38779-0082-09 and
38779-0388-09
ML-104 to ML 103
This Weeks New Posted Charts 02/05/2016
Outpatient 88300, 27726, and
29896
WC007-30 and 96101-59-25
performed on 01/05/2015
99358 and 99080 DOS 20155
ML106-95 / DOS 2016
97004, 97112, 97110, 97140,
and 97035 2015
64493-50 DOS 20155
97110 x 2 for each date DOS
2015
DMEPOS E0218 Water
circulation cold pad w/pump for
date of service 07/10/2015
ML104-95 DOS 2015
26442, 64721, and 26145
performed on 06/19/2015