10019632, 69L-7.020 - Florida Administrative Rules, Law, Code, Register

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Florida Department of State and Division of Library and Information Services

Notice: 10019632

Notice of Proposed Rule

Department:

DEPARTMENT OF FINANCIAL SERVICES

Division:

Division of Workers' Compensation

Chapter:

WORKERS' COMPENSATION MEDICAL REIMBURSEMENT AND UTILIZATION REVIEW

Overview

RULE:

69L-7.020	Florida Workers' Compensation Health Care Provider Reimbursement Manual
69L-7.100	Florida Workers' Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASCs)

PURPOSE:

The purpose of these proposed rules is to adopt the 2010 version of the Florida Workers’ Compensation Reimbursement Manual for Health Care Providers and the Florida Workers’ Compensation Reimbursement Manual for Ambulatory Surgical Centers, respectively. These rule making activities will also result in publication of the reimbursement rates authorized by the Three Member Panel, pursuant to Section 440.13(12), F.S., at its public meeting held on December 18, 2009. In addition, both proposed rules will adopt updated versions of the American Medical Association’s Current Procedural Terminology, CPT© 2010 Professional Edition, Copyright 2009, the American Medical Association’s “Healthcare Common Procedure Coding System, Medicare’s National Level II Codes Manual” HCPCS 2010, Copyright 2009, Ingenix Publishing Group, and the American Dental Association Current Dental Terminology, CDT® 2009/2010, Copyright 2008. In addition, the 2010 ICD-9-CM Professional for Hospitals, Volumes 1, 2 and 3, International Classification of Diseases, 10th Revision, Clinical Modification, Copyright 2009, Ingenix, Inc. (American Medical Association); the Physician ICD-9-CM 2010, Volumes 1 & 2, International Classification of Diseases, 9th Revision, Clinical Modification, Copyright 2009, Ingenix, Inc. (American Medical Association).

SUMMARY:

The proposed rules address revisions to Rules 69L-7.020, (Florida Workers’ Compensation Health Care Provider Reimbursement Manual) and 69L-7.100, F.A.C. (Florida Workers’ Compensation Reimbursement Manual for Ambulatory Surgical Centers). Each proposed rule incorporates an updated (2010) edition of its respective reimbursement manual, which publishes the maximum reimbursement allowances (MRAs) as established by the Three Member Panel, pursuant to Section 440.13(12), F.S. The rules also incorporate updated reference materials, guidelines regarding the medical billing process, and utilize efficient new formats. Additionally, the ASC Manual, as amended, incorporates certain policy language currently contained within Rule 69L-7.602, F.A.C. (Florida Workers’ Compensation Medical Services Billing, Filing and Reporting Rule).

RULEMAKING AUTHORITY:

440.13(4), (14), (14)(b), 440.591 FS.

LAW:

440.13(7), (12), (14)(c) FS.

PRINT PUBLISH DATE:

6/17/2011 Vol. 37/24

COMMENTS:

From 6/17/2011 To 7/8/2011 (21 Days)
The public comment period for this notice has already expired.

REFERENCE MATERIALS:

No reference(s).

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