69L-7.501. Florida Workers' Compensation Reimbursement Manual for Hospitals

(1) The Florida Workers’ Compensation Reimbursement Manual for Hospitals, (Hospital RM), 2020 Edition, effective 06/23, is incorporated herein by reference. The policy, procedures, principles and standards in the Hospital RM supplement the requirements and responsibilities established throughout rule Chapter 69L-7, F.A.C., Workers’ Compensation Medical Reimbursement and Utilization Review.

(2) The Current Procedural Terminology (CPT®), 2020 Professional Edition, Copyright 2019, American Medical Association; 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; the ICD-10-PCS 2020: The Complete Official Codebook, American Medical Association, Copyright 2019, Optum360, LLC; the 2020 HCPCS Level II Professional Edition, American Medical Association, Copyright 2020, Elsevier Inc.; and the CDT 2020, Dental Procedure Codes, Copyright 2020, American Dental Association, are incorporated herein by reference. A copy of the American Medical Association’s reference materials may be obtained from the American Medical Association’s website at https://commerce.ama-assn.org/store/ui. A copy of the CDT reference material may be obtained from the American Dental Association’s website at https://www.ada.org/en/publications/ada-catalog.

(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 Florida Workers’ Compensation Health Care Provider Reimbursement Manual (HCP RM), incorporated by reference into Rules 69L-7.020, and 69L-7.100 through 69L-7.750 F.A.C., which inform Health Care Providers and Insurers of their respective responsibilities in the billing, filing, reporting and review of worker’s compensation medical claims, are recognized for use in conjunction with the Hospital RM.

(5) The Department has determined that posting the documents referenced in subsections (1), (2), and (3) 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 6-9-87, Amended 6-1-92, 10-27-99, 7-3-01, Formerly 38F-7.501, 4L-7.501, Amended 12-4-03, 1-1-04, 7-4-04, 10-1-07, 1-1-15, 6-1-23.