ML106 -For Record Review Only
ML104 Complexity Factors
4 complexity factors required to constitute ML104
2 or more hours of face to face interview
2 or more hours of record review
2 or more hours of medical research by physician
4 or more hours spent on any combination of the above = 2 complexity factors.
6 or more hours spent on any combination of the above = 3 complexity factors.
Psychological Evaluation -The nature of the evaluation is psychiatric = 1 complexity factor
Addressing issue of causation if requested or if found to be an issue in the evaluation
Addressing issue of apportionment can be a complexity factor if there are:
3 or more employers
3 or more injuries to the same body system or region
2 or more injuries involving 2 or more body systems or regions
Addressing issue of denial or modification of treatment by the claims administrator
following Utilization Review