69L-7.100. Florida Workers' Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASCs)

(1) The Florida Workers’ Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASC RM), 2020 Edition, effective 07/23 is incorporated herein by reference. The policy, procedures, principles, and standards in the ASC RM supplement the requirements and responsibilities established throughout rule Chapter 69L-7, F.A.C., Workers’ Compensation Medical Reimbursement and Utilization Review.

(2) The ASC RM 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 RM, the Ambulatory Surgical Center shall refer to the Current Procedural Terminology (CPT®), 2020 Professional Edition, Copyright 2019, American Medical Association, which is incorporated herein by reference. The CPT® Assistant 2020, American Medical Association, Copyright 2019; the ICD-10-CM 2020: The Complete Official Codebook, American Medical Association, Copyright 2019, Optum360, LLC; and the ICD-10-PCS 2020: The Complete Official Codebook, American Medical Association, Copyright 2019 Optum360, LLC are also incorporated herein by reference. A copy of these reference materials may be obtained from the American Medical Association’s website at https://commerce.ama-assn.org/store/.

(3) The National Uniform Billing Committee (NUBC), Official UB-04 Data Specifications Manual 2021, version 15.00, July 2020, American Hospital Association, is incorporated herein by reference.  A copy of this manual can be obtained from the National Uniform Billing Committee’s website at https://www.nubc.org/.

(4) The CDT 2020, Dental Procedure Codes, Copyright 2020, American Dental Association, is incorporated herein by reference, for dental D codes. A copy of the CDT reference material may be obtained from the American Dental Association’s website at http://www.ada.org/en/publications/ada-catalog.

(5) The Department has determined that posting the publications referenced in subsections (1), (2), (3) and (4) on the Internet for purposes of public examination and inspection would constitute a violation of federal copyright law. These copyrighted materials may be viewed, during regular business hours, at the offices of:

1. Division of Workers’ Compensation, Bureau of Monitoring and Audit, 1579 Summit Lake Drive, Tallahassee, Florida 32317; or

2. The Florida Administrative Code and Register, R.A. Gray Building, 500 South Bronough Street, Tallahassee, Florida 32399-0250.

Rulemaking Authority 440.13, 440.591 FS. Law Implemented 440.13 FS. History–New 8-7-91, Amended 12-31-92, Formerly 38F-7.100, 4L-7.100, Amended 9-4-05, 8-19-07, 11-13-11, 9-28-15, 7-1-23.