Special Services Section 9

In Accordance with the N.C. Industrial Commission’s
Medical Fee Schedule & Subsequent Updates, 1996-2009

Bernadine Singh
Chief Medical Fee Examiner
N.C. Industrial Commission
E-mail: Bernadine.Singh@ic.nc.gov

NOTE 1: To purchase a complete copy of the American Medical Association’s Current Procedural Technology Codes, telephone Ingenix, Inc. at (800) INGENIX (464-3649), option 1, or go to http://www.shopingenix.com/modules/catalog/catalog_category.asp to order a CPT® code book online.

NOTE 2: Please report any problems or errors directly to Bernadine.Singh@ic.nc.gov.

NOTE 3: This page was last revised on February 20, 2009.

TABLE OF CONTENTS

Introduction	CPT Codes and Fees / Commission Assigned Codes
Evaluation and Management Section 3	Physical Medicine Section 10
Anesthesia Section 4 (effective April 1, 2000)	Chiropractic Fee Schedule Section 11 (effective March 1, 2001)
Surgery Section 5	Industrial Rehabilitation Section 12 (effective January 1996)
Radiology Section 6	Dental Fee Schedule Section 13 (effective May 1, 2007)
Pathology and Laboratory Section 7	Hospital and Ambulatory Surgical Center Section 14 (effective July 15, 2002)
Medicine Section 8	Forms Section 16 (effective February 1, 2000)
Special Services Section 9	Durable Medical Equipment/Supply Fee Schedule (effective January 1, 2008)

Special Services Section 9

CPT Code 99075 "Medical Testimony" is a fee set by the NCIC hearing officer. Pay per the hearing officer’s "Opinion and Award."

The Commission has ruled unofficially that travel to secure job replacement is a part of Rehabilitation services and covered under G.S. §97-25 when properly documented. Effective January 1, 2009, travel expense decreased to 55 cents a mile.

Job-site visits, reviewing video tapes, and viewing X-rays are covered under Rehabilitation services but need prior approval from the Insurance Carrier. These bills are not submitted to the Commission, but are paid by the Carrier.

Reimbursement for supplies and equipment must not exceed twenty (20) percent above the provider’s cost. An invoice may be required by the carrier before reimbursement is made.

There are some items that have no CPT codes, such as any type of supply or minor anesthesia. These must be entered as 99070.

Commission Assigned Codes

See Master File for Complete list

NCIC Code	Procedure Description	NCIC Allowance
MC001	Non-Paid services	no allowance
MC002	Miscellaneous approved services
MC003	No show appointment	no allowance
MC004	Follow-up days included in global fee	no charge allowed
MC005	Unauthorized provider
FS100	Flow meter	$100.00 per day
FS200	Flap monitoring	$100.00 per day
CS100	Cold study	$100.00

N.C. Industrial Commission ·   Medical Fees Section
4337 Mail Service Center ·   Raleigh, NC 27699-4337
Telephone: (919) 807-2503 ·   Fax: (919) 715-0282
Internet Address: http://www.ic.nc.gov/

Special Services Section 9

In Accordance with the N.C. Industrial Commission’s Medical Fee Schedule & Subsequent Updates, 1996-2009

Special Services Section 9

In Accordance with the N.C. Industrial Commission’s
Medical Fee Schedule & Subsequent Updates, 1996-2009