Except for a response to a request for information made pursuant to subdivision (f)(7), reports required under this subdivision shall be submitted on the "Primary Treating Physician's Progress Report" form (Form PR-2) contained in Section 9785.2, or in the form of a narrative report. If a narrative report is used, it must be entitled "Primary Treating Physician's Progress Report" in bold-faced type, must indicate clearly the reason the report is being submitted, and must contain the same information using the same subject headings in the same order as Form PR-2. A response to a request for information made pursuant to subdivision (f)(7) may be made in letter format. A narrative report and a letter format response to a request for information must contain the same declaration under penalty of perjury that is set forth in the Form PR-2: "I declare under penalty of perjury that this report is true and correct to the best of my knowledge and that I have not violated Labor Code § 139.3."
For dates of service prior to October 1, 2015, use Form PR-2 (Rev. 06-05). For dates of service on or after October 1, 2015, use Form PR-2 (Rev. 2015). Although ICD-10 coding is required on or after October 1, 2015, for a twelve-month period ending October 1, 2016, no medical treatment or medical-legal bill shall be denied based solely on an error in the level of specificity of the ICD-10 diagnosis code(s) used. Providers may use either version of the form until December 31, 2015. As of January 1, 2016, providers must use the 2015 version of the form.
By mutual agreement between the physician and the claims administrator, the physician may make reports in any manner and form.
For dates of service prior to October 1, 2015, use Form PR-3 (Rev. 06-05) or PR-4 (Rev. 06-05), as applicable. For dates of service on or after October 1, 2015, use Form PR-3 (Rev. 2015) or PR-4 (Rev. 2015), as applicable. Although ICD-10 coding is required on or after October 1, 2015, for a twelve-month period ending October 1, 2016, no medical treatment or medical-legal bill shall be denied based solely on an error in the level of specificity of the ICD-10 diagnosis code(s) used. Providers may use either version of the form until December 31, 2015. As of January 1, 2016, providers must use the 2015 version of the form.
Cal. Code Regs. Tit. 8, § 9785
2. Amendment of subsection (b) filed 11-11-78; effective thirtieth day thereafter (Register 78, No. 45).
3. Amendment of subsections (c) and (d) and new subsection (e) filed 7-11-89; operative 10-1-89 (Register 89, No. 28).
4. Amendment of section and NOTE filed 8-31-93; operative 8-31-93. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 93, No. 36).
5. New subsection (e) and subsection relettering filed 3-27-95; operative 3-27-95. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 95, No. 13).
6. Repealer and new section filed 11-9-98; operative 1-1-99 (Register 98, No. 46).
7. Amendment of subsections (e)(1), (f)(8) and (g) filed 12-22-2000; operative 1-1-2001 pursuant to Government Code section 11343.4(d) (Register 2000, No. 51).
8. Amendment of section and NOTE filed 5-20-2003; operative 6-19-2003 (Register 2003, No. 21).
9. Amendment of subsections (a)(1), (a)(8), (b)(3)-(4) and (g) and amendment of NOTE filed 12-31-2004 as an emergency; operative 1-1-2005 (Register 2004, No. 53). A Certificate of Compliance must be transmitted to OAL by 5-2-2005 or emergency language will be repealed by operation of law on the following day.
10. Certificate of Compliance as to 12-31-2004 order, including further amendment of subsections (a)(1) and (g), transmitted to OAL 4-29-2005 and filed 6-10-2005 (Register 2005, No. 23).
11. Amendment of subsections (b)(3) and (f)(6), new subsections (g) and (i), subsection relettering and amendment of NOTE filed 12-31-2012 as an emergency; operative 1-1-2013 pursuant to Government Code section 11346.1(d) (Register 2013, No. 1). A Certificate of Compliance must be transmitted to OAL by 7-1-2013 or emergency language will be repealed by operation of law on the following day.
12. Amendment of subsections (b)(3) and (f)(6), new subsections (g) and (i), subsection relettering and amendment of NOTE refiled 7-1-2013 as an emergency; operative 7-1-2013 (Register 2013, No. 27). A Certificate of Compliance must be transmitted to OAL by 9-30-2013 or emergency language will be repealed by operation of law on the following day.
13. Amendment of subsections (b)(3) and (f)(6), new subsections (g) and (i), subsection relettering and amendment of NOTE refiled 9-30-2013 as an emergency; operative 10-1-2013 (Register 2013, No. 40). A Certificate of Compliance must be transmitted to OAL by 12-30-2013 or emergency language will be repealed by operation of law on the following day.
14. Certificate of Compliance as to 9-30-2013 order, including amendment of subsections (b)(3)-(4) and (g), transmitted to OAL 12-30-2013 and filed 2-12-2014; amendments effective 2-12-2014 pursuant to Government Code section 11343.4(b)(3) (Register 2014, No. 7).
15. Amendment of subsections (a)(1)-(2) filed 2-12-2014; operative 7-1-2014 pursuant to Government Code section 11343.4 (Register 2014, No. 7).
16. Amendment of subsections (e)(1)-(2), (f)(8) and (h) filed 9-21-2015; operative 10-1-2015 pursuant to Government Code section 11343.4(b)(3) (Register 2015, No. 39).
Note: Authority cited: Sections 133, 4603.5 and 5307.3, Labor Code. Reference: Sections 4061, 4061.5, 4062, 4600, 4600.3, 4603.2, 4604.5, 4610.5, 4658.7, 4660, 4662, 4663 and 4664, Labor Code.
2. Amendment of subsection (b) filed 11-11-78; effective thirtieth day thereafter (Register 78, No. 45).
3. Amendment of subsections (c) and (d) and new subsection (e) filed 7-11-89; operative 10-1-89 (Register 89, No. 28).
4. Amendment of section and Note filed 8-31-93; operative 8-31-93. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 93, No. 36).
5. New subsection (e) and subsection relettering filed 3-27-95; operative 3-27-95. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 95, No. 13).
6. Repealer and new section filed 11-9-98; operative 1-1-99 (Register 98, No. 46).
7. Amendment of subsections (e)(1), (f)(8) and (g) filed 12-22-2000; operative 1-1-2001 pursuant to Government Code section 11343.4(d) (Register 2000, No. 51).
8. Amendment of section and Note filed 5-20-2003; operative 6-19-2003 (Register 2003, No. 21).
9. Amendment of subsections (a)(1), (a)(8), (b)(3)-(4) and (g) and amendment of Note filed 12-31-2004 as an emergency; operative 1-1-2005 (Register 2004, No. 53). A Certificate of Compliance must be transmitted to OAL by 5-2-2005 or emergency language will be repealed by operation of law on the following day.
10. Certificate of Compliance as to 12-31-2004 order, including further amendment of subsections (a)(1) and (g), transmitted to OAL 4-29-2005 and filed 6-10-2005 (Register 2005, No. 23).
11. Amendment of subsections (b)(3) and (f)(6), new subsections (g) and (i), subsection relettering and amendment of Note filed 12-31-2012 as an emergency; operative 1-1-2013 pursuant to Government Code section 11346.1(d) (Register 2013, No. 1). A Certificate of Compliance must be transmitted to OAL by 7-1-2013 or emergency language will be repealed by operation of law on the following day.
12. Amendment of subsections (b)(3) and (f)(6), new subsections (g) and (i), subsection relettering and amendment of Note refiled 7-1-2013 as an emergency; operative 7-1-2013 (Register 2013, No. 27). A Certificate of Compliance must be transmitted to OAL by 9-30-2013 or emergency language will be repealed by operation of law on the following day.
13. Amendment of subsections (b)(3) and (f)(6), new subsections (g) and (i), subsection relettering and amendment of Note refiled 9-30-2013 as an emergency; operative 10-1-2013 (Register 2013, No. 40). A Certificate of Compliance must be transmitted to OAL by 12-30-2013 or emergency language will be repealed by operation of law on the following day.
14. Certificate of Compliance as to 9-30-2013 order, including amendment of subsections (b)(3)-(4) and (g), transmitted to OAL 12-30-2013 and filed 2-12-2014; amendments effective 2-12-2014 pursuant to Government Code section 11343.4(b)(3) (Register 2014, No. 7).
15. Amendment of subsections (a)(1)-(2) filed 2-12-2014; operative 7-1-2014 pursuant to Government Code section 11343.4(Register 2014, No. 7).
16. Amendment of subsections (e)(1)-(2), (f)(8) and (h) filed 9-21-2015; operative 10/1/2015 pursuant to Government Code section 11343.4(b)(3) (Register 2015, No. 39).