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Chapter 4.5. Division of Workers' Compensation
Article 5.3. Official Medical Fee Schedule
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§9789.12.10. Coding; Current Procedural Terminology©, Fourth Edition.

(a) The coding, modifiers, guidelines, appendices and all other provisions of Current Procedural Terminology©, Fourth Edition (“CPT”), published by the American Medical Association are applicable to the bills submitted for physician and non-physician practitioner services, except: (1) any provision in the Physician Fee Schedule that conflicts with a provision in CPT will take precedence over the CPT, and (2) as otherwise specified in regulation. See section 9789.19 for the version of the CPT by date of service.

(b) Copies of Current Procedural Terminology©, Fourth Edition may be purchased from the American Medical Association:

P.O. BOX 930876
ATLANTA, GA 31193-0876

Or over the internet at: or

Or through the American Medical Association's toll free order line: (800) 621-8335.

(c) See section 9789.19 for CPT codes that shall not be used for reporting of or payment for physician services, by date of service.

(d) For coding requirements for physician-administered drugs, biologicals, blood products, and vaccines, see section 9789.13.2.

(e) For HCPCS codes to bill splint and cast materials, see section 9789.19, by date of service.

Note: Authority: Sections 133, 4603.5, 5307.1 and 5307.3, Labor Code. Reference: Sections 4600, 5307.1 and 5307.11, Labor Code.


1. New section filed 9-24-2013; operative 1-1-2014. Submitted to OAL as a file and print only pursuant to Government Code section 11340.9(g) (Register 2013, No. 39).

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