Effective June 24, 2023, the DFEC and DEEOIC Programs for the Office of Workers’ Compensation Programs (OWCP) will enhance bill processing to prevent denials related to accepted conditions if an approved authorization is on file for the billed service.

No changes are necessary for submitting authorization requests or bills. All approved authorizations will need to match the billing OWCP Provider, OWCP Claimant, date(s) of service, and procedure code. In addition, the DEEOIC program will require the billed diagnosis code to match the authorized diagnosis code.

The following are updates specifically for the DEEOIC program:

  • New EOB denial reason 90972 will post if a billed diagnosis code does not match the diagnosis code on the approved authorization.
    • The following new EOB denial reason will appear on the Remittance Voucher (RV): “Matching authorization is available, but dx on bill is different from the approved authorization”
  • New authorization Edit 61342 will post if an authorization is submitted with a non-payable diagnosis code.

For additional information, please contact our Call Center at the number listed below, where a Call Center representative will be happy to assist you.

  • Division of Energy Employees Occupational Illness Compensation (DEEOIC): 1-866-272-2682
  • Division of Federal Employees' Compensation (DFEC):1-844-493-1966
Posted Date