Registered Massage Therapy Reference Manual
Contents
1. Wounds 04400 Foreign bodies superficial Includes foreign bodies in splinters chips the eye Burns 05100 Burns chemical Burns 05200 Burns electrical Burns 05300 Burns scalds from heat Intracranial 06000 Intracranial injuries other injuries Intracranial 06200 Concussions injuries Environmental 07000 Environmental conditions other trauma Environmental 07110 Frostbite trauma Environmental 07120 Hypothermia trauma Environmental 07200 Heat and light effects trauma Environmental 07300 Air pressure effects trauma Environmental 12560 Welder s flash trauma Environmental 12610 Hearing loss or impairment trauma deafness Musculoskeletal 17000 Musculoskeletal connective Non traumatic disorders tissue diseases and disorders musculoskeletal system and connective tissue diseases and disorders Musculoskeletal 17100 Arthritis arthropathies and disorders related disorders Musculoskeletal 17210 Sciatica not traumatic Use muscles tendons disorders joints other injuries for traumas Musculoskeletal 17231 Herniated disc Including other disc disorders pathologies e g degenerative disc disease Musculoskeletal 17293 Radiculitis not traumatic Use muscles tendons disorders joints other injuries for traumas Musculoskeletal 17310 Bursitis not traumatic Use muscles tendons disorders joints other injuries for traumas M2. Worker information Worker s last name Enter the worker s last name If possible it should match the name on the worker s British Columbia CareCard First name Enter the worker s first name Initials should not be used If possible it should match the name on the worker s British Columbia CareCard Workers Claim Enter the WorkSafeBC claim number specific to this injury To confirm the claim number by contacting the WorkSafeBC Call Centre please number ensure you have the correct injury date birth date and PHN for the worker Worker s Provide the worker s self reported job title Occupation Date of injury The date when the work related injury occurred In the case of occupational diseases this is the date when medical attention was first sought you may wish to check this date by accessing Online Claim Status Is worker currently working Indicate yes if the worker is working either full hours reduced hours or altered duties Clinical Report Reports should include at least the following information The expected duration of treatment and discharge date The expected treatment outcome and recommendations Injured Worker s current clinical status An outline of the treatment goals The estimated number and frequency of visits Name of treating therapist A rational for continued treatment should be included in all reports requesting ongoing treatm
3. Explanatory Codes A Troubleshooting Guide 17 HIBC MSP Teleplan Rejection Explanatory Codes and Descriptions sseesseesseesresnssrresresrrssrrssens 18 Appendix E Service Location Codes orent tren rnn rana Re ea tux Ru unE n Une EEUEEKRRE RR RENS nnmnnn 20 Appendix F CSA Side of Body Codes for WorkSafeBC Reporting amp Invoicing Purposes 21 Appendix G CSA Body Codes for WorkSafeBC Reporting amp Invoicing Purposes 22 Appendix H CSA Nature of Injury Codes for WorkSafeBC Reporting amp Invoicing Purposes 25 Registered Massage Therapy Services Reference Manual www worksafebc com Page 2 of 30 1 0 Introduction This manual is intended to assist with specific business processes related to doing business with WorkSafeBC Workers Compensation Board of BC This is not a stand alone document and it is intended that this manual be used in conjunction with the Registered Massage Therapy Services Memorandum of Agreement and all the related Schedules Please ensure that you and your staff understand the content of this manual Confirming a WorkSafeBC Claim Status WorkSafeBC will only pay for services where the claim has been accepted by WorkSafeBC When booking an initial appointment please ask the patient whether the injury is possibly work related If so ask for the claim number If the Injured Worker does not yet have
4. MSP Teleplan Invoice for Treatment Services form 267 at http www worksafebc com forms default asp can be used if you choose to fax invoices to the WorkSafeBC A separate invoice is required for each individual worker If a worker does not have a PHN please fax the invoice directly to Payment Services at 604 279 7590 Billing WorkSafeBC via HIBC MSP Teleplan The information you submit to Teleplan must be correct and consistent before the system will allow payment for your services The date of service payee number and fee item must exactly match the date of service payee number and form fee item on the invoice you transmit to us If they do not match your invoice will be rejected and you will need to correct the information and resubmit the invoice To submit invoices via Teleplan you need clinic billing software that is compatible with Teleplan For more information contact a medical software vendor or the Medical Software Vendor Association at www msva ca or by calling the MSVA at 1 800 663 2094 Alternately you can submit through Teleplan by using a service bureau A BK explanatory code tells you that the WorkSafeBC has received your submission and is currently making a decision on it Some complex claims can take more than 60 days to make an entitlement decision so your patience is appreciated A Refusal code AA means that the patient does not have a PHN and or the patient is not a British Columbia resident
5. for the clinic The details that correspond to this payee number will be used to issue payment If you are an individual without a practitioner number or a Clinic that wants to obtain a payee number you will need to contact the HIBC Registered Massage Therapy Services Reference Manual www worksafebc com Page 11 of 30 Service Recipient Information Service Recipient s last Enter the worker s last name If possible it should match the name name on the worker s British Columbia CareCard Service Recipient s first Enter the worker s first name Initials should not be used If possible name it should match the name on the worker s British Columbia CareCard Select male or female Birth Date Enter the birth date of the injured worker Personal health number Enter the worker s Personal Health Number as shown on the British Columbia CareCard If the worker does not have a PHN indicate this on the form Otherwise you will be charged a transaction fee for WorkSafeBC WCB Enter the WorkSafeBC claim number specific to this injury To Claim number confirm the claim number by contacting the WorkSafeBC Call Centre please ensure you have the correct injury date birth date and PHN for the worker Date of Injury The date when the work related injury occurred In the case of occupational diseases this is the date when medical attention was first sought you may wish to check this date by accessing Online Claim Status Diagnostic Co
6. outpatients receive scheduled services including emergency department or any other hospital setting where outpatients receive services Note Excludes day care surgical patients Patient s Private Home Service is provided in a patient s own home Note Includes service provided in a group homes where on site nursing or other health professional support care is not provided but excludes assisted living residences and other residential facilities see Residential Care Assisted Living Resident Practitioners Office In Community Service is provided in a practitioner s office Note Excludes practitioner s offices that are located within a publicly administered health care facility see Practitioner s Office In Publicly Administered Facility Includes services provided by a physician chiropractor dentist optometrist podiatrist Physical Therapist and massage therapist Mental Health Centre Service is provided in a publicly administered mental health centre to an outpatient Note Excludes mental health facilities that are primarily residential in nature see Residential Care Assisted Living Includes CRESST Facilities Practitioner s Office In Publicly Administered Facility Service is provided in a practitioner s office located within a publicly administered health care facility e g Hospital Primary Care Centre Clinic D amp T Centre etc Registered Massage Therapy Ser
7. CT FOR MORE INFO required contact WorkSafeBC Health Care Services The rest of the codes and explanatory codes can be found on the MSP website Note These aforementioned explanation codes are those that occur most frequently and do not comprise all of the codes that may be referenced Registered Massage Therapy Services Reference Manual www worksafebc com Page 19 of 30 Appendix E Service Location Codes Revised CODE Revised DISCRIPTOR Revised DEFINITION Residential Care Assisted Living Residence Service is provided to a patient in a licensed residential care facility or registered assisted living residence Note Excludes small group homes where no professional health care support care is available and includes extended care facility within a hospital Hospital Emergency Room Unscheduled Patient Service is provided in a hospital emergency department for a patient who presents for emergent or urgent treatment Note Excludes hospital outpatients who receive services on a scheduled basis within an emergency department see Hospital Outpatients Hospital Inpatient Service is provided for a patient who is an impatient of a hospital Note Excludes patients located within a designated extended care unit within a hospital see Residential Care Assisted Living Residence Hospital Outpatient Service is provided in outpatient and or ambulatory clinics where
8. If the worker does not have a personal health number please write that information on the form 267 Invoice For Treatment Services and fax the invoice directly to Payment Services at 604 279 7590 Otherwise you will be charged a non electronic transaction fee for billing on paper Please refer to Appendix D Explanatory Codes A Troubleshooting Guide for more information Registered Massage Therapy Services Reference Manual www worksafebc com Page 7 of 30 5 0 WorkSafeBC Injury Coding The WorkSafeBC has adopted a standardized injury coding system This is a key element for case management and early intervention Injury coding consists of three components Service location codes Appendix E Side of body codes Appendix F Body part codes Appendix G Nature of injury codes Appendix IH Diagnostic codes ICD 9 access online This coding is mandatory on all invoices It allows for expedited matching of invoices to claims resulting in timely payment Codes can be accessed on line at www worksafebc com under health care providers gt invoice codes Registered Massage Therapy Services Reference Manual www worksafebc com Page 8 of 30 Appendix A Massage Treatment Report Guidelines The Massage Therapy Report Form 83D48 is the template for all Massage Treatment Reports More specific guidelines and formats will be developed at a later date Date of report Enter the date the report was written in the followin
9. WORKING TO MAKE A DIFFERENCE worksafebc com Registered Massage Therapy Reference Manual March 2013 Registered Massage Therapy Services Reference Manual www worksafebc com Page 1 of 29 Table of Contents 1 0 lei e EE 3 Confirming a WorkSafeBC Claim Gratis 3 Contact informalo EE 3 gola coL 4 WorkSafeBC Online Information sess nnnr enne nnne rn eren nnne 4 2 0 SEFVICS DESC UC eec 4 2 1 Physician Relonalessepon niin ada ta Ul ra ipea pee Eeer 4 2 2 Treatment Dm ratien etn EE en pd ee oae seg ee aed Re addi ee ga ue ep RAE ex EeE Eech Eege 4 2 39 Concurrent EEN 5 GE MER ei dzeie im pc 5 3 0 Reporting and Communication Requirements eeeeeeeeeeeee eene 5 3 1 Se ell PTT 5 3 2 COMMUNICATION EE 6 3 3 Treatment Extension Requests for treatment beyond 5 weeks AA 6 4 0 NAV OIG ING mee 6 EECH 6 Invoice Tele TE H Billing WorkSafeBC via HIBC MSP Telenlan nnne nennen nnne nennen 7 5 0 WorkSafeBC Injury Cod ng erret cetacieacctene ss cetncneacctanenieenneracaieana SEES ERR ERR Era a Ra EEE 8 Appendix A Massage Treatment Report Guidelines esee 9 Appendix B Invoice for Treatment Services 267 Reference Guide 11 Appendix C Fee SCN me 14 Appendix D
10. a claim number please ask the worker to provide the number as soon as s he receives one You may confirm a WorkSafeBC claim status by e Checking online at www worksafebc com Click on the view claim status access claim status and enter the worker s claim number or e Calling the WorkSafeBC Call Centre If the status of the claim is pending this means that a decision has not yet been made on whether it will be an accepted claim In this circumstance the provider may choose to bill the worker privately If the claim is subsequently accepted the provider must reimburse 100 for all Massage Therapy costs paid by the worker prior to the date the claim was accepted and bill WorkSafeBC directly at contracted rates Contact Information Fax reports and invoices 604 233 9777 or toll free 1 888 922 8807 Payment Services 604 276 3085 or toll free 1 888 422 2228 Health Care Services 604 232 7787 or toll free 1 866 244 6404 The WorkSafeBC Call Centre 604 231 8888 or toll free 1 888 967 5377 HIBC MSP Contact for Medical and Health Care Professionals Vancouver 604 456 6950 Other areas of B C toll free 1 866 456 6950 http www health gov bc ca msp infoprac index html Registered Massage Therapy Services Reference Manual www worksafebc com Page 3 of 30 2 0 Forms Forms are available for download at www worksafebc com under Forms tab The Your Registered Massage Therapist and You pamphlet can
11. also be downloaded from the health care providers section under the Massage Therapists Resources tab WorkSafeBC Online Information The WorkSafeBC has a Health Care Provider Centre site that can be accessed online at www worksafebc com The Health Care Provider Centre is designed to help health care providers better understand our programs services and business process Registered Massage Therapists and other health care providers can access useful information tailored specifically to their practice including The status of a claim Invoice payment status Injury coding tables Instructions and forms for billing amp reporting Contact information Resources such as brochures and post surgical rehabilitation guidelines Post operative protocols Service Description The goal of massage therapy is to assist Injured Workers reach the functional levels required to return to pre injury work in a safe durable and timely manner This requires the Registered Massage Therapist to have an understanding of the Injured Worker s pre injury work hours and duties Return to work and massage therapy treatment may occur concurrently There are three categories of treatment e Standard Treatment e Out of Clinic Treatment for circumstances where the worker is unable to attend the clinic e Extenuating Circumstances Treatment for severely injured workers that require more extensive treatment e g lymphedema 2 1 Physician Referral A re
12. clude the RMT s GST registration number Registered Massage Therapy Services Reference Manual www worksafebc com Page 16 of 30 Appendix D Explanatory Codes A Troubleshooting Guide The following is a list of codes that commonly arise in the course of billing the WorkSafeBC through Teleplan Please check this list first for help if the answer is not here check the complete list of codes received from your software vendor or HIBC MSP There is also a current list of WorkSafeBC explanatory codes which includes more detailed information on the WorkSafeBC Online website at www worksafebc com If you are still unable to resolve the problem please call WorkSafeBC Payment Services at 604 276 3085 or toll free 1 888 422 2228 HIBC Codes HIBC Descriptions WorkSafeBC Explanation AA PHN Number is missing or invalid If the patient does not have a personal health number please write that information on the form otherwise there will be a charged transaction fee for the billing on paper BK Your claim submission is being held pending Waiting for WorkSafeBC Claim WorkSafeBC Notice of Approval match Waiting for Treatment Extension Waiting for Claim decision Waiting for Payment decision Waiting for Concurrent Treatment Authorization ET WorkSafeBC refused payment Fee Item Limit You have exceeded the allowable Exceeded limit for this fee item SA WorkSafeBC refused your claim subm
13. date of injury Before providing more than 5 weeks of treatment Before providing each 6 month period of Extenuating Circumstances Treatment Before providing Out of Clinic Treatment Claim Owner approval is not required to provide services for treatments that occur during the first 8 weeks of the claim for accepted claims All reports sent to the Worker s Attending Physician must be copied to WorkSafeBC If the Registered Massage Therapist s assessment identifies findings that are inconsistent with the injury on the accepted claim the Registered Massage Therapist must notify the Claim Owner and Attending Physician within one 1 business day of the assessment The Claim Owner will then determine whether or not the findings are part of the claim The Registered Massage Therapist will promptly report to WorkSafeBC any injury to an Injured Worker occurring during treatment 3 3 Treatment Extension Requests for treatment beyond 5 weeks Extensions beyond 5 weeks will only be authorized where there is a rationale for ongoing treatment A report from the Registered Massage Therapist must be received by at least five 5 business days prior to the treatment end date Do not treat beyond the treatment end date without prior approval The report should include the following Injured Worker s current clinical status An outline of the treatment goals The estimated number of visits Frequency of visits The expected duration of treatment and d
14. de ICD 9 These codes can be found on online at code http www worksafebc com health care providers default asp Side of Body Code See Appendix F Body Part Code See Appendix G Nature of Injury Code See Appendix H Injury Information Entry of all the code fields is mandatory for payment to be processed Codes can be found in the Appendices or on line Registered Massage Therapy Services Reference Manual www Worksafebc com Page 12 of 30 Service Location Code See Appendix E Date of Service Indicate the specific date s Massage Therapy service was provided to the injured worker Fee Code Indicate the fee code s for the specific Massage Therapy service s provided as outlined in Schedule B2 of the Agreement Amount dee e fee amount s for the specific Massage Therapy service s provided as outlined in Schedule B2 of the Agreement Number of service units The number of service units is 1 for each initial visit and subsequent visit The number of service units may be more than 1 for Out of Clinic Treatment fee item 19155 Extenuating Circumstances Treatment item 19192 and photocopying Service Description Describe the specific type of treatment provided to the Injured Worker for each treatment date of service as stated in the Fee Schedule Claim number is optional You may not have the Injured Worker s WorkSafeBC claim number at the time of initial treatment Including the claim number in future claim submissions w
15. eet 43230 Foot feet heel s Foot feet 43800 Foot feet multiple locations Toe s 44000 Toe s toenail s Body Systems Body 50000 Immune and endocrine systems systems Body 50001 Circulatory system systems Body 50002 Digestive system systems Body 50004 Genito urinary system systems Body 50005 Musculoskeletal system systems joints tendons Body 50006 Nervous system for systems nervous shock breakdown A current list of WorkSafeBC injury codes is available on www worksafebc com Registered Massage Therapy Services Reference Manual www worksafebc com Page 24 of 30 Appendix H CSA Nature of Injury Codes for WorkSafeBC Reporting amp Invoicing Purposes Nature of Injury Codes CSA Z795 3 Trauma and musculoskelet al disorders Release 2 0 Effects of external agents and poisoning resulting from a single incident event or exposure plus diseases and disorders of the musculo skeletal system and connective Bones nerves 01000 Bones nerves spinal cord spinal cord trauma other Bones nerves 01100 Dislocations Displacement or dislocation spinal cord of bone or cartilage Includes subluxations partial displacement and fractured or broken cartilage Bones nerves 01200 Fractures Includes avulsion fractures spinal cord Bones nerves 01300 Spinal cord traumatic injuries s
16. ent Registered Massage Therapy Services Reference Manual www worksafebc com Page 10 of 30 Appendix B Invoice for Treatment Services 267 Reference Guide Invoice Number je number chosen by the provider to identify the invoice Enter the date of the invoice Invoice date must be after the date of service Enter the name of the clinic that provided service to the worker Practitioner number Enter the practitioner number of the Registered Massage Therapist who provided service to the worker The practitioner number may be the same as the payee number Payee Number Enter either the Payee number for the clinic or the treating Registered Massage Therapist s practitioner number if payment should be issued to the practitioner directly Payment will be issued to the account details for this payee number payment cannot be made without this information Mailing address for Enter the mailing address for that corresponds to the payee number payment Include street location city province and postal code You may use a stamp if filling out a paper form Telephone Number Enter the telephone number including the area code of the clinic where service was provided to the worker Fax Number Enter the fax number including the area code of the clinic where service was provided to the worker Please note The payee number can be your MSP practitioner number for an individual therapist Clinics could also obtain a payee number
17. enuating Report Report Report Circumstances treatment beyond six 6 months or as requested by WorkSafeBC e If requested by WorkSafeBC report must be received by WorkSafeBC within ten 10 business days from the date of the request For invoicing purposes the date of request is considered day ZERO 0 e 10 00 deduction if the report is received by WorkSafeBC eleven 27 00 per Report 27 00 per Report Registered Massage Therapy Services Reference Manual www worksafebc com Page 15 of 29 11 business days from the date of the request Telephone 19158 Initiated by Board Officer and or 25 00 25 00 25 00 25 00 25 00 Consultation with RMT Board Officer Billable for conversation time only for discussions regarding treatment related issues return to work and must be documented in clinical notes Billable for consultations up to FIFTEEN 15 minutes per Service Unit Limit ONE 1 per payee per accepted claim per day Not billable for discussion of administrative or performance issues Producing copies 19156 Requested by WorkSafeBC 22 36 22 36 22 36 22 36 22 36 first 5 pages Producing copies 19157 Requested by WorkSafeBC 1 15 per 1 15 per 1 15 per 1 15 per 1 15 per page every page over 5 page page page page pages Goods and Services 19932 Where applicable show PST and Tax GST GST separately for each line item not as a lump sum on an invoice In
18. fee 65 00 inclusive of 27 00 report fee Subsequent Treatment 19151 Limit ONE 1 per payee per day per accepted claim Service date must be later than that of Initial Visit No concurrent treatments are allowed unless approved by a Board Officer 30 00 30 00 31 00 32 00 33 00 Registered Massage Therapy Services Reference Manual www worksafebc com Page 14 of 30 Extenuating Circumstances Treatment 19192 e ONE 1 Service Unit equals 18 00 18 00 18 00 FIFTEEN 15 minutes of treatment e Must receive prior approval from the Board Officer e Maximum of EIGHT 8 Service Units six 6 treatment service units plus two 2 travel e M Billable from Initial Visit instead of fee item codes 19150 or 19151 e Billable if the Massage Treatment Report Form is received before the Initial Visit and before the end of the six 6 month period 18 00 18 00 Out of Clinic Treatment 19155 e Limit ONE 1 per day per payee 15 84 15 84 15 84 per accepted claim e Service date must be later than that of the Initial Visit e MAXIMUM of four 4 service units per visit two 2 treatment service units plus two 2 service units for travel 15 84 15 84 Massage Treatment Report Requested by WorkSafeBC 19190 e Forregular Treatment Beyond five 27 00 per 27 00 per 27 00 per 5 weeks or Ext
19. ferral from a physician must be received before a Registered Massage Therapist can treat an Injured Worker The referral must be kept in the clinical record 2 2 Treatment Duration e The Registered Massage Therapist can provide up to 5 weeks of treatment with a maximum of three visits per week and up to a maximum of 15 Subsequent Treatments Claim Owner verbal approval is required for any treatments that occur 8 weeks after the date of injury e Treatment is limited to one massage visit per day Registered Massage Therapy Services Reference Manual www worksafebc com Page 4 of 30 e There are no per session treatment time lengths prescribed rather the length of each session is to the clinical discretion of the RMT and not based on the amount paid per session e Extenuating Circumstances Treatment and Out Of Clinic Treatment are time based and are billed in units of 15 minutes Two 15 minute time units can be used for travel to the treatment location 2 3 Concurrent Treatment Authorization is typically not given for worker to attend more than one type of treatment in a given time period The Injured Worker must choose between attending physiotherapy chiropractic or massage therapy Massage therapy is typically not authorized when a worker is attending a treatment program Concurrent treatments may be considered under special circumstances 2 4 Worker Education The Registered Massage Therapist should provide education on the followi
20. g format yyyy mm dd Date of Service Enter the date of service in the following format yyyy mm dd Report Type When to submit Initial Date of initial visit Progress Every 6 months of approved treatment or upon request from a Board Officer Other Report To request authorization for further treatment home visits or extenuating circumstances treatment Provider information Name Enter the name of the Clinic or Registered Massage Therapist who provided service to the worker Payee Number Enter the MSP practitioners number of the Registered Massage Therapist who provided service to the worker or the Payee number for the clinic where service was provided to the worker Enter the name of the clinic where the service was provided to the sine Name worker if applicable Mailing Provide the current mailing address of the clinic or Registered address stamp Massage Therapist Phone Number Enter the telephone number including the area code of the clinic where service was provided to the worker or the number of the Registered Massage Therapist if there is no associated clinic Fax Number Enter the fax number including the area code of the clinic where service was provided to the worker or the fax number for the Registered Massage Therapist if there is no associated clinic Registered Massage Therapy Services Reference Manual www worksafebc com Page 9 of 29
21. ic complications other Complications peculiar to injuries medical or surgical procedures or following traumatic injuries includes anaphylactic shock and post traumatic oseteoarthritis Other traumatic 09710 Crushing injuries injuries Systemic Toxic and non toxic diseases diseases or disorders affecting and disorders systems of the body Disease of blood 11000 Blood and blood forming and blood organs diseases forming organs Nervous system 12000 Nervous system and sense diseases organs diseases Nervous system 12410 Carpal tunnel syndrome not For traumatic carpal tunnel diseases traumatic syndrome use nerves traumatic inj ex spinal cord Nervous system 12500 Eye disorders not traumatic Do not use for traumatic diseases injuries Circulatory 13000 Circulatory system diseases system diseases other Registered Massage Therapy Services Reference Manual www worksafebc com Page 27 of 30 Circulatory 13310 Heart attack system diseases myocardial infarction Circulatory 13610 Stroke system diseases Circulatory 13710 Raynaud s syndrome Use for vibration induced system diseases phenomenon white finger white finger disease Respiratory 14200 Respiratory diseases of system diseases upper tract other Respiratory 14220 Respiratory chronic condition of Includes chronic sinusitis system diseases upper tract pharyngitis Respirator
22. ill facilitate payment Registered Massage Therapy Services Reference Manual www worksafebc com Page 13 of 30 WORK WORKING TO MAKE A DIFFERENCE Health Care Services Mailing Address BC PO Box 5350 Stn Terminal Vancouver BC V6B 5L5 Appendix C Fee Schedule Location Richmond BC 6951 Westminster Highway www worksafebc com Telephone 604 232 7787 Fax 604 231 8424 MASSAGE THERAPY SERVICES Toll free within BC 1 888 967 5377 Description of Fee Item Fee Item Code WorkSafeBC Business Rules Date Range Jan 01 2011 Dec 31 2011 Jan 01 2012 Dec 31 2012 Jan 01 2013 Dec 31 2013 Jan 01 2014 Dec 31 2014 Jan 01 2015 Dec 31 2015 Initial Visit with Massage Treatment Report 19150 Limit ONE 1 per payee per claim Billable if the Massage Treatment Report is received Report must be received by WorkSafeBC within three 3 business days from the date of the initial visit For invoicing purposes the date of assessment is considered zero 0 Deduction of 10 00 will be applied if treatment report is not received within three 3 days of the initial visit Deduction of 27 00 will be applied if treatment report is not received within ten 10 days of the initial visit 62 00 inclusive of 27 00 report fee 62 00 inclusive of 27 00 report fee 63 00 inclusive of 27 00 report fee 64 00 inclusive of 27 00 report
23. ischarge date and The expected treatment outcome and recommendation 4 0 Invoicing General It is the Registered Massage Therapist s responsibility to confirm the worker s claim status When a pending status becomes accepted the Registered Massage Therapist must reimburse the worker 100 for all Massage Therapy costs paid prior to the date the claim was accepted and invoice WorkSafeBC directly according to the fee amounts in Schedule B of the Agreement A Registered Massage Therapist must not charge any additional fees to an Injured Worker who has a claim accepted by the WorkSafeBC e g therabands user fees administrative fees ice pack etc Registered Massage Therapy Services Reference Manual www worksafebc com Page 6 of 30 WorkSafeBC may not pay for invoices that are submitted greater than 90 days from the date of service WorkSafeBC will hold all payments until 30 days after the provision of the service A Registered Massage Therapist shall not invoice the WorkSafeBC for missed late or cancelled appointments under any circumstances Invoice Submission All invoices must use the fee codes described in Schedule B of the Agreement Appendix C GST where applicable must be entered as a separate line item for each date of service on the invoice using fee code 19932 Good and Service Tax GST Invoices for Registered Massage Therapy Services should be submitted to the WorkSafeBC by electronic submission via HIBC
24. ission only Only one type of visit per claim is one course of treatment acceptable per day If payable per day clarification required contact WorkSafeBC Payment Services SB WorkSafeBC refused your claim submission The Board Officer did not authorize Concurrent treatment not authorized If this course of treatment due to clarification required contact WorkSafeBC Board other authorized treatments Officer SJ Unable to locate WorkSafeBC Form The form you invoiced for was not received and registered to that Please verify payee number and date of service ees Ah claim on invoice and resubmit with revised info WD WorkSafeBC claim disallowed If clarification The claimants WORKSAFEBC required contact WorkSafeBC Payment Services claim was disallowed WV WorkSafeBC claim treatment refused If Claims Board Officer did not clarification required contact the Board Officer authorize this course of treatment Registered Massage Therapy Services Reference Manual www worksafebc com Page 17 of 30 WM WorkSafeBC refused your claim submission This service has exceeded the Treatment limit exceeded If clarification authorized time limit required contact WorkSafeBC Board Officer XS WorkSafeBC refused claim Claim suspended This claim has been suspended pending further investigation If clarification until the WorkSafeBC hears from required contact WorkSafeBC Board Officer the
25. lage Neck 2009 Vocalcords s Neck 13000 Larynx Neck 14000 Laryngopharym Neck 15000 Pharynx Neck 80001 Neck and shoulder Trunk Chest 22000 Chest amp Cd Chest 22200 Esophagus Chest 22300 Heat Cd Chest 22400 Bronchus Chest 22500 Lung s pleura_ 22800 Chest multiple internal locations Back 23200 Back thoracic region Includes 12 vertebrae just below cervical vertebrae of the neck the trapezius muscle the cervico Registered Massage Therapy Services Reference Manual www worksafebc com Page 22 of 30 thoracic thoraco lumbar regions Level 1 Body part level 3 Usage note Back lumbar region Includes 5 vertebrae in lower port on of back and lumbo sacral region Back 23300 Back sacral region Back 23400 Back coccygeal region Includes tail bone Back 23800 Back multiple regions Abdomen 24200 Stomach Abdomen 24300 Spleen Abdomen 24410 Bladder Abdomen 24420 Kidney s Abdomen 24491 Ureter Abdomen 24520 Intestine small Abdomen 24530 Intestine large colon rectum Abdomen 24610 Liver Abdomen 24620 Gallbladder Abdomen 24630 Pancreas Abdomen 24800 Abdomen multiple internal locations Pelvic 25100 Hip s region Pelvic 25200 Pelvis region Pelvic 25300 Bu
26. ng topics What the worker can expect from the treatment Pain control Self management of the injury Prevention of re injury The concept of early re activation The benefits of a return to work program 3 0 Reporting and Communication Requirements 3 1 Reporting 3 1 1 Massage Treatment Report e A report is due within 3 business days of the Initial Visit Initial Visit being day zero The Initial Visit will not be paid if the report is not received e 10 will be deducted from the initial visit fee if the report is not received within 3 business days and 27 if the report is not received within 10 business days e A report is required when requesting an extension of treatment beyond 5 weeks A report is required every 6 months for workers receiving treatment under Extenuating Circumstances Treatment e A report in addition to those listed above can be requested at anytime by the Claim Owner 3 1 2 Massage Therapy Reports are submitted on the Massage Therapy Report template Form 83D48 This form can be found on the WorkSafeBC website at http www worksafebc com forms default asp 3 1 3 Reports should be faxed to 604 233 9777 or toll free 1 888 922 8807 Registered Massage Therapy Services Reference Manual www worksafebc com Page 5 of 30 3 2 Communication The Registered Massage Therapist must have verbal approval from the Claim Owner under the following circumstances Before providing treatment that occurs 8 weeks after the
27. owed Contact claim DISALLOWED DO NOT RE BILL owner for more information Please do not rebill SERV NOT ALLOWED WITH SERV 512 WorkSafeBC service is not allowed 512 ALREADY PD REFER TO EP with another service already paid on this CONTRACT FOR CONCURRENCY date of service Please refer to the RULES contract 513 WorkSafeBC service is not entitled 513 SERVICE NOT ENTITLED ON CLAIM UM on this claim Contact claim owner for more information SERVICE IS NOT APPROVED OR 514 WorkSafeBC service is not 514 OUTSIDE ALLOWABLE GV approved or outside allowable entitlement ENTITLEMENT period Contact claim owner for more Registered Massage Therapy Services Reference Manual www worksafebc com Page 18 of 30 information MAXIMUM SERVICE UNITS 515 WorkSafeBC the maximum service 515 ENTITLED HAVE ALREADY BEEN UL units entitled have already been invoiced INVOICED Contact claim owner for more information PROOF NOT RECEIVED OR NOT 518 WorkSafeBC proof was not received 518 ACCEPTED CHECK CONTRACT SJ or not accepted Please check contract for FOR PROOF REQUIREMENTS proof requirements INVOICED AMOUNT WAS 528 ADJUSTED TO WORKSAFEBC FEE C8 528 WorkSafeBC invoice amount was SCHEDULE adjusted to the Fee Schedule Claim submission changed to the PENALTY APPLIED FOR PROOF appropriate MSP consultation rate plus the 534 TIMELINESS PLEASE REFER TO CV amount for fee item 19908 If clarification CONTRA
28. pinal cord Bones nerves 01400 Nerves traumatic injuries Includes traumatic carpal spinal cord ex spinal cord tunnel syndrome Muscles joints 02000 Muscles tendons joints other Includes tears to menisci injuries ligaments and articular cartilage Muscles joints 02100 Sprains strains Muscles joints 02101 Rotator cuff tear traumatic If due to repetitive motion use rotator cuff syndrome Wounds 03000 Wounds other open wounds Includes wounds with broken skin or outward opening beyond the superficial skin surface Wounds 03110 Amputations fingertip Includes bone loss Wounds 03190 Amputations except fingertip Includes bone loss Wounds 03200 Bites and insect stings Wounds 03300 Wounds avulsions Includes ripping or tearing away not involving bone excludes avulsion of joint capsule ligament muscle or tendon use muscles tendons joints other injuries Wounds 03400 Wounds cuts and lacerations Wounds 03700 Wounds punctures Wounds 04000 Wounds other closed wounds Includes blisters and friction burns Registered Massage Therapy Services Reference Manual www worksafebc com Page 25 of 30 Wounds 04100 Wounds abrasions and Includes traumatic scratches conjunctivitis of the eye use surface wounds bruises contusions for closed wounds Wounds 04300 Wounds bruises and Use for closed wounds contusions 3
29. seases and disorders other disorders Infectious and Infectious and 29000 Infectious and parasitic Classifies bacterial viral parasitic parasitic diseases diseases diseases ricketsial fungal and parasitic infections Registered Massage Therapy Services Reference Manual www worksafebc com Page 28 of 30 Cancers neoplasms and tumors Cancers 30000 Cancers neoplasms and neoplasms and tumors tumors Registered Massage Therapy Services Reference Manual www worksafebc com Page 29 of 30 Psychological disorders Psychological 52000 Psychological disorders or disorders syndromes Other Other 51000 Damage or loss of prosthetic devices Other 99990 Not yet diagnosed Describe symptoms in diagnosis A current list of WorkSafeBC injury codes is available on www worksafebc com Registered Massage Therapy Services Reference Manual www worksafebc com Page 30 of 30
30. ttock s region Pelvic 25400 Groin region Pelvic 25510 Scrotum region Pelvic 25520 Penis region Pelvic 25530 Genital region external region female Pelvic 25610 Prostate region Pelvic 25620 Testis testes region Pelvic 25630 Ovary ies region Pelvic 25640 Uterus region Pelvic 25800 Pelvis multiple regions region Upper extremities Shoulder 21000 Shoulder including clavicle Includes clavicle collar scapula bone humerus scapula shoulder blade and shoulder girdle Registered Massage Therapy Services Reference Manual www worksafebc com Page 23 of 30 Arm s 31100 Arm s upper Arm s 31200 Arm s elbow s Level 1 Level 2 Code Body part level 3 Usage note Arm s 31300 Arm s forearm s Arm s 31800 Arm s multiple locations Wrist s 32000 Wrist s Hand s 33000 Hand s except finger s Includes knuckles and the areas between the fingers Finger s 34000 Finger s fingernail s Includes distal phalanx phalanges medial phalanx phalanges and proximal phalanx phalanges Finger s 34001 Thumb or thumb and other finger s Leg s 41100 Leg s thigh s Leg s 41200 Leg s knee s Leg s 41300 Leg s lower Leg s 41800 Leg s multiple locations Ankle s 42000 Ankle s Classifies the hinge joint area between the foot and the lower leg Foot feet 43000 Foot feet other except heel s Foot f
31. usculoskeletal 17320 Synovitis not traumatic Use muscles tendons disorders joints other injuries for traumas Musculoskeletal 17330 Tendonitis not traumatic Use muscles tendons Registered Massage Therapy Services Reference Manual www worksafebc com Page 26 of 30 disorders joints other injuries for traumas Musculoskeletal 17340 Tenosynovitis not traumatic Use muscles tendons disorders joints other injuries for traumas Musculoskeletal 17391 Rotator cuff syndrome Use muscles tendons disorders not traumatic joints other injuries for traumas Musculoskeletal 17393 Epicondylitis not traumatic Use muscles tendons disorders joints other injuries for traumas Musculoskeletal 17394 Capsulitis not traumatic Use muscles tendons disorders joints other injuries for traumas Musculoskeletal 17901 Fibromyalgia fibrositis Use muscles tendons disorders myofascitis joints other injuries for traumas Other traumatic 09000 Traumatic injuries and injuries ENS Code disorders other Nature of injury type level 3 Other traumatic 09100 Asphyxiation strangulation injuries suffocation Other traumatic 09200 Drownings injuries Other traumatic 09300 Electrocutions electric shocks injuries Other traumatic 09500 Poisonings and toxic effects injuries Other Other traumatic 09600 Traumat
32. vices Reference Manual www worksafebc com Page 20 of 30 Appendix F CSA Side of Body Codes for WorkSafeBC Reporting amp Invoicing Purposes Side of body codes CSA Z795 Release 2 0 Side of body Code Usage Note Left Right Left and right Not applicable zUu mi r Use for body systems a major body part i e heart stomach or multiple other parts A current list of WorkSafeBC injury codes is available on www worksafebc com Registered Massage Therapy Services Reference Manual www worksafebc com Page 21 of 30 Appendix G CSA Body Codes for WorkSafeBC Reporting amp Invoicing Purposes Body part codes CSA Z795 Release 2 0 Level 1 Level 2 Code Body part level 3 Usage note Head RENE CERNERET Cranial Brain Includes brain stem Use for moe m concussion or other intracranial injuries Cranial 401200 Scalp Includes skin hair temporal bones ao Fas eeo Leg Forhasd Includes eyebrows Eye s Includes conjunctiva cornea eyeball inside and outside of the eyelids iris lacrimal glands lens optic nerve orbit and retina CEN Nose external Klee internal GENE Face 103500 Jaw hin Face 103610 ms Face 03620 Tongue Tooth teeth Face 03630 Face 03800 Face multiple locations 10009 Neck soft tissues Includes throat muscle skin subcutaneous tissue veins and arteries carti
33. worker No decision as to entitlement can be rendered until more information is received XR WokrSafeBC refused claim Injured Worker not Claim has been rejected as the covered under the WCB Act If clarification worker was not covered under required contact WorkSafeBC Board Officer WCB Act Accounts for visits and forms are not payable Injury may be covered by another insurer HIBC MSP Teleplan Rejection Explanatory Codes and Descriptions WorkSafeBC WorkSafeBC Explanatory HIBC HIBC Explanatory Code Code Code Description Code Description WorkSafeBC refused claim Invalid nature 146 INVALID NATURE OF INJURY CODE S1 of injury code Please resubmit with amended information WorkSafeBC refused claim Invalid body 147 INVALID AREA OF BODY CODE SZ part code Please resubmit with amended information WorkSafeBC refused claim Invalid side of 148 INVALID ANATOMICAL POSITION S2 body code Please resubmit with amended information WorkSafeBC claim submitted to 158 Invalid PHN 2W _ WorkSafeBC on paper refused by WorkSafeBC INFORMATION MISSING PLEASE 501 RESUBMIT WITH MISSING GW 501 WorkSafeBC information missing INFORMATION Please resubmit with missing information DUPLICATE SERVICE A SERV WAS b07 WorkSafeBC duplicate service A 507 ALREADY PAID FOR THIS DATE OF HW service was already paid for this date of SERV DO NOT RE BILL service Please do not rebill 511 WorkSafeBC claim has been 511 CLAIM REJECTED OR WD rejected or disall
34. y 14410 Bronchitis system diseases Respiratory 14420 Emphysema system diseases Respiratory 14440 Extrinsic allergic alveolitis system diseases pneumonitis Respiratory 14490 Chronic obstructive pulmonary system diseases disease other Respiratory 14500 Pneumoconioses other Includes bauxite fibrosis system diseases graphite fibrosis and stenosis Respiratory 14510 Pneumoconiosis coal workers Includes anthracosis black system diseases P Code Nature of injury type level 3 lung miner s asthma Respiratory 14520 Asbestosis For cancer use cancers system diseases neoplasms and tumors Respiratory 14530 Silicosis system diseases Respiratory 14900 Respiratory system diseases system diseases other Respiratory 14991 Reactive airway dysfunction system diseases syndrome R A D S Digestive system 15000 Digestive system diseases and diseases disorders other Digestive system 15390 Hernia other Excludes herniated disc diseases Genitourinary 16000 Genitourinary system disease system disease and disorder and disorder Disorders skin 18200 Dermatitis other Classifies inflammation of and the subcutaneous skin resulting from contact tissue with allergens or irritant substances Disorders skin 18900 Skin and subcutaneous tissue and diseases and disorders other subcutaneous tissue Other systemic 19000 Systemic diseases and Includes scleroderma di
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