The Colorado Division of Workers’ Compensation (DOWC) adopted several RBRVS fields and attributes for Rule 18: Medical Fee Schedule in 2019. One of these is the status code attributes that describe how a HCPCS or CPT® medical code will be reimbursed. Status codes also explain policy rules such as active codes, deleted codes, or bundled services.
Below is the list of current DOWC Status Codes. See Rule 18-4(A)(3) for information on the RBRVS fields, attributes and DOWC-created codes.
As of 2018, CPT 99070 and 97010 are no longer payable. Both codes have a status of “B”, which means payment is always bundled into the payment for other provided services. There will never be separate payments for status “B” codes.
99070 – Supplies and materials provided by the physician or other qualified healthcare professional
According to Rule 18-6(A)(3), “Supplies necessary to perform a service or procedure are not separately reimbursable. Only supplies that are not an integral part of a service or procedure are considered to be over and above those usually includes in the service or procedure.”
When reporting supplies that are not included with a service, bill Pinnacol with the most accurate HCPCS code that describes the supply.
97010 – Application of a modality; hot or cold packs
CPT code 97010 will be denied as bundled. Application of hot or cold packs is included with any therapy performed. The supply used for the modality should not be billed and is not separately payable.
Pinnacol conducts pre- and post-payment documentation reviews. If your documentation does not support the services being billed, your request for payment could be denied or you could receive a letter requesting a refund based on an overpayment. If you have questions, please contact us at billingsuccess@pinnacol.com or 303.361.4940.