Updates & Corrections

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Updates

Payment policy updates
Payment policy updates
Posting date Description
May 4, 2010 Independent Medical Examinations – This modifies the billing rules for codes 1129M, 1132M and 1133M and adds three new billing codes for multiple claims. Changes are effective April 1, 2010
October 26, 2009

The Psychiatric Payment Policies were updated to include services payable to psychiatric ARNPs. PDF FilePsychiatric Payment Policies
September 30, 2009 Effective November 1, 2009 the department's Chronic Pain Management Policy will be updated. Please see Provider Bulletin 09-07 for details.
September 21, 2009

PDF FileEffective July 31, 2009, psychiatric ARNPs may treat injured workers.”
September 15, 2009 As of September 26, 2009, the department will continue to use the Average Wholesale Price provided by First DataBank® for Prescription Drug Pricingprescription drug pricing.
August 25, 2009

July2009Updates Physicians final report for medical only claims.  Establishes the Physicians Final report as an option for medical only claims.
July 21, 2009 July2009UpdatesImpairment Rating Exam and Report by Attending Provider - This clarifies who may perform impairment ratings and when the ratings require prior authorization.
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Fee schedules updates
Fee schedule updates
Posting date Description Updated version
March 22, 2010 New HCPCS codes effective 4/1/2010 Oct2009Updates New HCPCS Codes
March 3, 2010 Effective 1/1/2010, the state mileage rate is $0.50 per mile None.
January 11, 2010 The following orthotic codes require licensure but do not contain a Y in the licensure column of the fee schedule. Oct2009Updates Orthotic Codes updates
December 8, 2009 ASC fee schedule code additions that will be effective 01/01/2010. Oct2009Updates ASC Codes Additions for 2010
December 8, 2009 ASC fee schedule code deletions that will be effective 12/31/09. Oct2009Updates Deleted ASC Codes for 2010
December 7, 2009

CPT® and HCPCS codes invalid after 12/31/2009.

 Oct2009Updates Deleted CPT® and HCPCS Codes for 2010
December 7, 2009 Comma Delimited File of Additional CPT® and HCPCS codes effective 1/1/2010. Oct2009Updates January 2010 Updates (Comma Delimited file)
December 7, 2009 Additional CPT® and HCPCS codes effective 1/1/2010. Oct2009Updates January 2010 Updates
October 15, 2009 Chronic Pain Management SIMP Follow up codes 2014M and 2015M must be billed by the minute.  Please click on the link to the PDF Billing Codes Instructions document for more details. Oct2009Updates Billing Codes Instructions (SIMP follow up codes)
September 15, 2009 Additional HCPCS codes effective October 1, 2009 Oct2009Updates October 2009 Updates
August 25, 2009 Physicians final report for medical only claims.  Payment code, amount ($25) and effective date. 2009Updates 1026M Fee Schedule Update
July 6, 2009 The following procedures will not be covered by Labor and Industries in Ambulatory Surgery Center facilites effective August 15, 2009. July2009Updates August 2009 Updates
June 29, 2009 Additional CPT® and HCPCS codes effective 7/1/2009. July2009Updates July 2009 Updates
June 16, 2009

Fee's for the following CPT ® codes are being updated based on RVU changes from CMS.

CPT ® code Non-Facility Fee Facility Fee
93555
$195.67
$195.67
93555-26
$76.30
$76.30
93555-TC
$119.37
$119.37
93556
$272.58
$272.58
93556-26
$78.14
$78.14
93556-TC
$195.05
$195.05
None.
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Corrections

Payment policies corrections
Payment policy corrections
Posting date Page(s) Description
   

None at this time...

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Fee schedule corrections
Fee schedules corrections
Posting date Description Updated version
January 12, 2010

Codes G0339 and G0340 are not covered in ASC facilities.

 None
July 6, 2009

The maximum fee for Plan Implementation Referral Cap, per referral was incorrectly listed in the Vocational Services section of the 2009 Labor and Industries Payment Policies.  The correct maximum fee is:

Description Applicable Codes Maximum Fee
Plan implementation Referral Cap, per referral 0840V, 0841V $6,818.00
None.
June 30, 2009 ASC Fee Schedule corrections for codes NOT covered. July2009Updates July 2009 ASC Fee Schedule corrections
June 22, 2009

Some fees were incorrectly listed in the July 1, 2009 fee schedule. Listed below are the corrections.

HCPCS Code Non-Facility Setting Facility Setting
J1675
$3.26
$3.26
R0075-UN
$82.43
$82.43
R0075-UP
$54.95
$54.95
R0075-UQ
$41.21
$41.21
R0075-UR
$32.97
$32.97
None.
June 19, 2009 The following CPT ® codes 70554, 70555, 70557, 70558, and 70559 were inadvertently listed as covered in the fee schedule. These procedures are NOT Covered. None.
June 16, 2009

CPT® code 88380 was inadvertently listed as By Report in the fee schedule. This code is Not Covered.

  None.