W5 (355)    ADJUSTMENT REASON (161.91)

Name Value
CODE W5
STATUS EFFECTIVE DATE
  • 2013-06-02 00:00:00
    STATUS:   ACTIVE
    FEE USE:   NOT APPLICABLE
  • 2014-07-01 00:00:00
    STATUS:   INACTIVE
    FEE USE:   APPLICABLE
DESCRIPTION EFFECTIVE DATE
  • DESCRIPTION:   
    Medical provider not authorized/certified to provide treatment to injured workers in this jurisdiction. (Use with Group Code CO or OA)
ASSOCIATED SUSPEND CODE File: 161.27, IEN: 4
SUSPENSION DESCRIPTION 
Medical provider not authorized/certified to provide treatment to injured workers in this jurisdiction. (Use with Group Code CO or OA)