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Chapter 4.5. Division of Workers' Compensation
Subchapter 1. Administrative Director--Administrative Rules
Article 5.5. Application of the Official Medical Fee Schedule (Treatment)

New query

§9792. Determination of the Fee.

APPENDIX C: RATIOS APPLIED TO REVISE CERTAIN DRG WEIGHTS IN CALIFORNIA


APPENDIX C: RATIOS APPLIED TO REVISE CERTAIN DRG WEIGHTS IN CALIFORNIA

Number

DRG

Ratio

004

Spinal Procs

0.6283

008

Peripheral/Cranial Nerve & Orth OR Nervous Sys. Procs

0.8082

025

Seizures and Headaches: AD WO CC

0.7485

029

Traumatic Stupor and Coma: AD WO CC

1.0025

032

Concussion: AD WO CC

0.8749

042

Intraocular Proc Exc. Retina, Iris and Lens

1.0661

063

Other Ear, Nose, Mouth and Throat OR Procs

0.8753

112

Percutaneous Cardiovascular Procs

0.8409

140

Angina Pectoris

0.7834

143

Chest Pain

0.8417

160

Hernia Proc: AD Exc. Inguinal or Femoral, WO CC

0.9016

162

Hernia Proc: AD Inguinal or Femoral, WO CC

0.8672

209

Major Joints and Limb Reattachment, Lower Extremity

0.9500

210

Hip and Femur, Exc Major joint Proc: AD W CC

1.1800

211

Hip and Femur, Exc Major joint Proc: AD WO CC

0.9726

214

Back and Neck Proc W CC

0.9674

215

Back and Neck Procs WO CC

0.9556

217

Wound Debridement and Skin Graft Exc. Hand

0.5717

218

Lower Extr/Humerous Exc. Hip, Foot and Femur: AD W CC

1.0298

219

Lower Extr/Humer. Exc. Hip, Foot and Femur: AD WO CC

0.9681

221

Knee Proc W CC

0.8177

222

Knee Proc WO CC

1.0382

223

Maj. Shoulder/Elbow Proc/Other Upper Extrem. Proc W CC

0.8850

224

Shoulder/Elbow/Forearm Proc exc. Major Joint Proc WO CC

1.0122

225

Foot Proc

1.0008

227

Soft Tissue Proc WO CC

0.9443

228

Major Thumb/Joint Proc, or Other Hand or Wrist Proc W CC

0.9063

229

Hand and Wrist Proc, Exc. Major joint Proc WO CC

1.0367

231

Local Excision/Removal Int. Fix. Devices Exc. Hip & Femur

0.7341

232

Arthroscopy

0.8166

234

Oth. Musculoskel. Sys/Connective Tissue OR Procs WO CC

0.8133

236

Fracture of Hip and Pelvis

0.9790

243

Medical Back

0.7609

251

Frac, Sprain, Strain, Disloc Forearm, Hand/Foot: AD WO CC

0.9012

254

Frac, Sprain, Strain, Disloc Up Arm/Low Leg ex Foot: AD W CC

1.0031

266

Skin Graft/Debridement Exc. Skin Ulcer or Cellulitis WO CC

1.1306

277

Cellulitis: AD W CC

0.7910

278

Cellulitis: AD WO CC

0.8654

281

Trauma to Skin, Subcutaneous Tiss and Breast: AD WO CC

0.9709

415

Infectious and Parasitic Disease OR Proc

0.4907

418

Postoperative and Post traumatic Infection

0.6801

440

Wound Debridement for Injury

0.7738

441

Hand Proc for Injury

0.9914

443

Other Proc for Injury WO CC

1.0024

445

Traumatic Injury: AD WO CC

0.8112

450

Injury/Poison/Drug: AD WO CC

0.6657

455

Other Injury/Poisoning and Toxic Effect Diagnosis WO CC

0.7483

461

OR Proc with Diagnosis of Other Contact with Health Services

0.9207

HISTORY

1. New Section filed with OAL on 2/23/99; Effective 4/1/99.

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