RULE NO.: RULE TITLE:
69L-7.100: Florida Workers' Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASCs)
These changes are being made in response to comments received as part of the record for the public hearing held on
To comply with the requirements of Chapter 2011-255, Laws of Florida, the Summary of Statement of Estimated Regulatory Costs is amended to read as follows: The Department has determined that the proposed rule will not have an adverse impact on small business or likely increase, directly or indirectly, regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC that has been prepared by the Department is summarized as follows: The proposed rule is not likely to; 1) directly or indirectly have an adverse impact on economic growth, private sector job creation or employment, or private sector investment in excess of $1 million in the aggregate within 5 years after the implementation of the rule; 2) directly or indirectly have an adverse impact on business competitiveness, including the ability of persons doing business in the state to compete with persons doing business in other states or domestic markets, productivity, or innovation in excess of $1 million in the aggregate within 5 years after the implementation of the rule; or 3) directly or indirectly increase regulatory costs, including any transactional costs, in excess of $1 million in the aggregate within 5 years after the implementation of the rule. In addition, the proposed rule does not impose additional costs on the Department; nor does it impose any additional costs on any state or local government entity. Accordingly, the Department has determined that the proposed rule will not require legislative ratification.
Text of proposed rule with changes:
69L-7.100
(1) The Florida Workers’ Compensation Reimbursement Manual for 0 Edition, (ASC Reimbursement Manual) is incorporated by reference as part of this rule. The ASC Reimbursement Manual contains the Maximum Reimbursement Allowances determined by the Three-Member Panel, pursuant to Section 440.13(12), F.S., and establishes reimbursement policies, guidelines, codes and maximum reimbursement allowances (MRAs) for services provided to an injured worker in connection with a surgical procedure performed in an Ambulatory Surgical Center.
(2) The ASC Reimbursement Manual refers to a number of procedure codes and modifiers that are consistent with the Current Procedural Terminology (CPT®), developed and published by the American Medical Association. When a service or procedure is performed that does not have a code listed in the ASC Reimbursement Manual, the Ambulatory Surgical Center shall refer to the Current Procedural Terminology (CPT®), 2010 Copyright 2010, American Medical Association, which is hereby incorporated by reference as part of this rule. In addition, the rule incorporates the 2010 ICD-9-CM Professional for Hospitals, Volumes 1, 2 and 3, International Classification of Diseases, 910th 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).
(3) The Current Dental Terminology (CDT-2009/2010), Copyright 2008, American Dental Association, and the HCPCS Level II, A resourceful compilation of HCPCS codes Healthcare Common Procedure Coding System, Medicare’s National Level II Codes, HCPCS 2010, Twenty-second Edition, Copyright 2009, Ingenix Publishing Group, are incorporated by reference as part of this rule, for dental D codes, injectable J codes, and other medical services or supply codes as specified in the ASC Reimbursement Manual.
(4) No change.
The remainder of the rule reads as previously published.