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Billing Pinnacol for Contracted Interpretation Services

As of Jan. 1, 2022, the Colorado Division of Workers’ Compensation requires certification
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The Colorado Division of Workers’ Compensation (DOWC) Rule 18 established billing codes and maximum allowable fees effective January 1, 2023. Contracted interpreters should follow the requirements in their individual contracts to determine which fees and services may be billed despite Rule 18 potentially allowing a higher maximum fee.

The DOWC created an Interpreter Invoice Form for billing interpretation services. When billing for interpretation services, contracted interpreters must follow the guidelines below. If any of this information is missing from the invoice, the bill may be denied.

  • DOWC billing codes should be used. Many of Pinnacol’s X codes will not be valid for dates of service after Dec. 31, 2022.
  • Business name and tax ID should be listed on the invoice.
  • The injured worker’s name and the Pinnacol claim number should be included. The claim number can be found on Pinnacol’s Provider Portal.
  • The interpreter’s certification should be identified.
  • The name of the interpreter listed on the bill must match the name of the interpreter on the certificate Pinnacol has on file. This includes first, middle and last names and any additional titles or suffixes that are relevant.
  • The interpretation language should be listed.
  • One interpreter and one injured worker should be listed per invoice. This allows the interpreter’s certification and language to be verified and billed accurately.
  • Multiple dates of service may be billed on the same invoice if interpretation was performed for the same injured worker by the same interpreter.
  • Each date of service should be listed on a separate line.
  • Each date of service must identify the provider and appointment information.
  • The total amount of time interpretation services were provided should be listed on the invoice.
  • The name of the Pinnacol representative who authorized the service must be noted on the bill.

Here are some additional billing guidelines:

  • Interpreters must obtain prior authorization for services from the claims management team except for initial or emergency treatment. Authorization is required for additional visits.
  • Interpretation services are not payable when performed at a facility or ambulatory surgery center for both inpatient and outpatient procedures. Payment for interpretation services is included in the facility’s reimbursement.
  • Payments are based on billed units of 15-minute increments. The invoice should reflect the number of units and the total billed amount.
  • Bills must be submitted no later than 90 days from the date of service.
  • Reimbursement for mileage and time to medical appointments is not available within the seven-county Denver metro area.

- Mileage accrued from clinic to clinic is not billable.

- Mileage within the same city in Colorado, regardless of the county, is not billable.

- Time while driving is not billable.

  • To be reimbursed for travel outside the Denver metro area or the interpreter’s origin city, bills must include the address of the interpreter’s location of origin before traveling, the destination address, the clinic name and the total number of miles traveled.

Below are the correct billing codes for medical appointments. Billing the incorrect code could result in a denial or delay in payment.

  • Z0710 Certified Spanish interpreter billed in 15-minute increments
  • Z0711 Qualified Spanish interpreter billed in 15-minute increments
  • Z0712 Non-Spanish interpreter billed in 15-minute increments
  • T1013 ASL interpreter billed in 15-minute increments
  • Z0713 On-demand video or audio remote interpreting (all languages)
  • Z0720 Cancellation or no-show (all languages)
  • Z0772 Mileage (when approved)

Below are the correct billing codes for non-medical appointments. Billing the incorrect code could result in a denial or delay in payment.

  • X97045 Non-medical Spanish interpreter per minute
  • X97046 Non-medical non-Spanish interpreter per minute
  • X99730 Written translation of recorded statement or deposition per word
  • X99735 Document translation per page
  • X99721 Notary fee

If you have any questions, please contact Pinnacol’s provider relations team at provider_management@pinnacol.com or 303.361.4945.

References

Colorado Division of Workers’ Compensation, Rule 18

Colorado Division of Workers’ Compensation Interpreter Invoice Form

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