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.

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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.

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

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

• Policy alert #2020-07: Payment for Personal Protective Equipment - COVID-19 State of Emergency
• Policy alert #2020-06: Post-Acute COVID-19 Syndrome Testing - COVID-19 State of Emergency
• Policy alert #2020-05: Payment for Disposable Masks or Facial Covering - COVID-19 State of Emergency
• Policy alert #2020-04: Temporary Policy Update: Pre-Surgical COVID-19 Lab Testing COVID-19 State of Emergency
• Policy alert #2020-03: Temporary Telehealth Policy for Check-in Services - COVID-19 State of Emergency
• Policy alert #2020-02:Temporary Telehealth Policy for Vocational Rehabilitation Services - COVID-19 State of Emergency
• Policy alert #2020-01:Temporary Telehealth Policy - COVID-19 State of Emergency

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

Billing

• 2018 Clarification Physical Therapy Services
• 2018 Clarification Pass Through Billing
• 2018 Clarification Pricing Override Process
• 2018 Clarification Time Based Billing

• Cardiac Clearance Medical Position Paper

• 2017 BWC coding clarification, proper coding of qualitative and quantitative drug screens

• Preauthorization of durable medical equipment - Clarification as to the monetary requirements for durable medical equipment (DME) requiring the provider to obtain prior authorization from the managed care organization (MCO)
• When durable medical equipment may be considered an artificial appliance

• Proper coding of Prolonged Evaluation and Management Services without Patient Contact

• Proper Coding and Billing of Percutaneous Implantation of Neurostimulator Electrode Arrays

• Clarification of taping versus strapping and correct billing codes