NORTH CAROLINA INDUSTRIAL COMMISSION

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Disclaimer

NC Workers’ Compensation Medical Fee Schedule Professional Codes and Fees

Notice to Citizens

The five character codes included in the NC Industrial Commission Medical Fees Schedule are obtained from Current Procedural Terminology (CPT®), copyright 2004 by the American Medical Association (AMA). CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians.

The responsibility for the content of the Medical Fees Schedule is with the State of North Carolina Industrial Commission and no endorsement by the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in the Medical Fees Schedule. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Any use of CPT outside of the NC Industrial Commission Medical Fees Schedule should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Applicable FARS/DFARS apply.

License for Use of Physicians’ Current Procedural Terminology (CPT) Fourth Edition, Effective January 16, 2003

This Fee Schedule includes CPT-4 numeric identifying codes for reporting medical services and procedures, which are copyrighted by the American Medical Association and used by permission. Any user of CPT-4 outside this fee schedule should refer to the Physician’s Current Procedural Terminology.

CPT codes, descriptions and material only are copyright 2002 American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT. AMA does not directly or indirectly practice medicine or dispense medical services. CPT is a trademark of the American Medical Association.

As an end user, you are authorized to use CPT only as contained in the following authorized materials for the purposes of utilizing or applying the North Carolina Workers’ Compensation Medical Fee Schedule.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA Web Site, http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing- your-practice/coding-billing-insurance/cpt.shtml. Applicable FARS/DFARS restrictions apply to government use.

Disclaimer of Warranties and Liabilities

CPT is provided “as is” without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. The responsibility for the content of this file/product is with the North Carolina Industrial Commission and no endorsement by the AMA is intended or implied. AMA is only responsible for the medium, which supplies the CPT information.

The North Carolina Industrial Commission disclaims responsibility for any liability attributed To End User Use Of The CPT. The North Carolina Workers’ Compensation Medical Fee Schedule is designed to be an accurate and authoritative source of information about medical coding and reimbursement. Every reasonable effort has been made to verify its accuracy, and all information is believed reliable at the time of publication. Absolute accuracy, however, cannot be guaranteed.

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