US · guidance
CMS Pub. 100-05, ch. 5, § 10.8.2
Workers' Compensation (WC) Development
The COBC develops to determine whether there is coverage primary to Medicare through WC
insurance. The COBC determines the nature of the injury using the diagnosis code(s) submitted on
the claim and through additional development, as necessary. The MSP auxiliary record added to
CWF includes the diagnosis code(s) relating to that injury. If, after the COBC's initial development,
the lead contractor later determines that benefits have been exhausted under WC, it shall post the
termination date following the instructions in §10.1. If the lead contractor receives information
through recovery development efforts that serves to modify the information that is contained on CWF,
it sends a CWF Assistance Request to the COBC via ECRS (See§10.2.1).
History
(Rev. 39, Issued: 10-21-05; Effective Date: 10-01-05; Implementation Date: 11-19-05)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
480035c909a6238657c6e543f5d11b6e11d9ebfcace9870d7a43ea30615c4f56
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