OhioBWC - Provider - Service:  (Billing and Reimbursement Manual)

Billing and Reimbursement Manual

All BWC-certified providers should have a copy of BWC's Billing and Reimbursement Manual. The manual explains the billing procedures for medical providers, who are treating injured workers under the Health Partnership Program.

Note: Should you have arrived on this Web page as a result of a search engine (or other) link, be advised that these files contain material that is copyrighted by the American Medical Association. You are forbidden to download the materials unless you read, agree to and abide by the provision of the copyright statement. Read the copyright statement now.

For your convenience, you can download and print a specific chapter or the entire manual from here. To download a specific chapter, click on the chapter title. If you want to download the entire manual, click on each chapter title and download each chapter one at a time.


BWC has developed a frequently asked questions document specifically for medical providers to address COVID-19 related issues. To download, click here


Future effective policies
To alert providers about upcoming changes, BWC will periodically post policies with a future effective date.

Title Effective date Download/Print

Table of Contents

Quarterly Update Highlights

Preamble

Chapter 1 - Ohio Bureau of Workers' Compensation System
This chapter includes information about employer types; managed care organization roles/responsibilities; provider eligibility; reporting an injury; guidelines for treatment, coding and reimbursement; and other BWC processes and procedures.
Presumptive approval guidelines
MCO standard prior authorization table
Medical documentation policy

MCO Directory

Chapter 2 - Services
This chapter includes information about practitioners, hospitals, ambulatory surgical centers, outpatient medication, vocational rehabilitation, home health agencies, nursing homes and other BWC-certified provider services.
Beryllium Policy
BWC Recognition of ICD-10-CM Codes for "Pain"
Cardiac Clearance for Non-Cardiac Surgery
New Medical Technologies and Procedures

Chapter 3 - Vocational Rehabilitation Services
This chapter includes information about vocational rehabilitation services.

New/Revised/Updated Policies


Policy alerts
BWC will periodically issue policy alerts to provide further clarification on specific policies. To download the latest policy alerts, click on any of the links below.

Temporary Policy Expansions under COVID-19 emergency

Billing

Cardiac clearance Drug screens Durable medical equipment Evaluation and management services Neurostimulators Taping vs. strapping