Mississippi Administrative Code › Title 20 - Labor › Part 2 - Mississippi Workers' Compensation Medical Fee Schedule › INTRODUCTION › Section 20-2-V - HOW TO INTERPRET THE FEE SCHEDULE

Current through June 25, 2024
For each procedure, the Fee Schedule table includes the
				  following columns and details (if applicable):
Code Icons
Add-on Codes
+ denotes procedure codes that are considered "add-on" codes
				  as defined in the CPT book.
Modifier 51 Exempt
Ø denotes procedure codes that are exempt from the use
				  of modifier 51 and are not designated as add-on procedures/services as defined
				  in the CPT book. Modifier 51 exempt services and procedures can be found in
				  Appendix E of CPT 2019.
APC J Status
J1 applicable to APC payments. See the Inpatient Hospital and
				  Outpatient Facility Payment Schedule and Rules section for more information.
J1* a Mississippi state-specific status indicator applicable
				  to APC payments. See the Inpatient Hospital and Outpatient Facility Payment
				  Schedule and Rules section for more information
Telemedicine-eligible.
* denotes those CPT codes that may be used for reporting
				  synchronous (real-time) telemedicine services when appended by modifier 95.
State-Specific Code
[INFINITY] indicates a code specific to the State of
				  Mississippi or a code with a description altered by the State of
				  Mississippi.
Code
This Fee Schedule uses 2019 CPT, CDT, HCPCS, and Mississippi
				  state-specific codes.
Modifiers
In the HCPCS section modifiers that affect payment are listed
				  in this column. See the Modifier and Code Rules section for more information
				  regarding the modifiers.
Description
This Fee Schedule uses CPT 2019 medium descriptions. Some
				  HCPCS code descriptions have been modified by the State of Mississippi.
MAR
This column lists the total maximum allowable reimbursement
				  as a monetary amount. Procedures with a $0.00 in the MAR column are not covered
				  or are not reimbursed.
PC Amount
Where there is an identifiable professional and technical
				  component to a procedure, the portion considered to be the maximum allowable
				  reimbursement for the professional component is listed in the PC Amount column.
				  Procedures with a $0.00 in the PC Amount column are considered one hundred
				  percent (100%) technical. See Modifiers and Code Rules for additional
				  information.
TC Amount
Where there is an identifiable professional and technical
				  component to a procedure, the portion considered to be the maximum allowable
				  for the technical component is listed in the TC Amount column. Procedures with
				  a $0.00 in the TC Amount column or where the TC column Amount column is blank
				  are considered one hundred percent (100%) professional. See Modifiers and Code
				  Rules for additional information.
FUD
Follow-up days (FUD) included in a surgical procedure's
				  global charge are listed in this column.
Postoperative periods of 0, 10, and 90 days are designated in
				  the Fee Schedule as 000, 010, and 090 respectively. The following special
				  circumstances are also listed in the postoperative period:
MMM Designates services furnished in uncomplicated maternity
				  care. This includes antepartum, delivery, and postpartum care.
XXX Designates services where the global concept does not
				  apply.
YYY Designates services where the payer must assign a
				  follow-up period based on documentation submitted with the claim. Procedures
				  designated as YYY in the Fee Schedule include unlisted procedure codes.
ZZZ Designates services that are add-on procedures and as
				  such have a global period that is determined by the primary procedure.
Assist Surg
The assistant surgeon column identifies procedures that are
				  approved for an assistant to the primary surgeon whether a physician, physician
				  assistant (PA), registered nurse first assistant (RNFA, RA), or other qualified
				  health care professional for reimbursement as an assistant under the Fee
				  Schedule.
APC Amount
Ambulatory Payment Classification (APC) is a payment method
				  for facility outpatient services. The APC Amount shall constitute the
				  reimbursement amount for both hospital based and freestanding outpatient
				  facilities.