In Accordance with the N.C. Industrial
Commission’s
1996 Medical Fee Schedule and Subsequent Updates
Jennifer Gudac
Chief Medical Fee Examiner
N.C. Industrial Commission
E-mail: gudaca@ind.commerce.state.nc.us
NOTE 1: To utilize these updates, you may require the original
North Carolina Workers’ Compensation Medical Fee Schedule
available by calling Medicode at
(877) INGENIX (464-3649).
NOTE 2: This page was last revised on May 17, 2002.
Table of Contents
Recent changes will be displayed in bold text.
On March 1, 1996, the N.C. Industrial Commission (NCIC) started processing medical bills using the 1996 Medical Fee Schedule. Medical bills will be approved by the 1996 fee schedule and subsequent updates contained in this document. Regardless of the date of service, bills will be processed according to the current schedule and updates unless specific instructions contained herein define effective dates. The Commission will be glad to review any medical bills in question.
When processing physician or professional medical bills, the Current Procedural Terminology (CPT) codes may be changed only after discussing the proposed change with the Medical Provider and obtaining an agreement that it can be changed. The medical bill analysis shall clearly show that the CPT code was changed and shall state the reason.
The 1996 N.C. Industrial Commission Medical Fee Schedule may be purchased through Medicode. (877) INGENIX (464-3649).
Questions regarding the application of the Fee Schedule may be directed to the North Carolina Industrial Commission Medical Fees Section.
N.C. Industrial Commission
Medical Fees Section
4337 Mail Service Center
Raleigh, NC 27699-4377
(919) 733-5055
Comments
Codes considered approved "BY REPORT" must be sent to the Chief Medical Fee Examiner marked "PERSONAL". These bills will be entered on our computer and returned to the Insurance Company or Self-Insurer.
The Industrial Commission has given permission for the processor to pay bills that are listed
"BY REPORT" if charges don’t exceed $50.00 without submitting them to the Industrial Commisssion.
The Industrial Commission does not allow for acupuncture and "no show" visits. Massage Therapy by a licensed massage therapist is paid per agreement.
THE FOLLOWING FEE SCHEDULE UPDATES
AND NOTES ARE ARRANGED ACCORDING
TO THE SECTION OF THE 1996 FEE
SCHEDULE TO WHICH THEY APPLY.
CPT Descriptions in this document may be abbreviated. For complete descriptions, please refer to the most current version of the American Medical Association’s Current Procedural Terminology.
Note: Effective March 1, 2001, the Commission deletes all CPT codes not found in the current AMA listings. Furthermore, the Commission will annually adopt new codes as well as delete old codes as released by the American Medical Association.