(1) The Florida Workers� Compensation Reimbursement Manual for Ambulatory Surgical Centers, 2011 Edition, http://www.flrules.org/Gateway/reference.asp?No=Ref-00686 (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 items and 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 Professional Edition, Copyright 2009, American Medical Association, which is hereby incorporated by reference as part of this rule. In addition, the rule incorporates the 2010 ICD-9-CM for Hospitals, Volumes 1, 2 and 3, International Classification of Diseases, 9th Revision, Clinical Modification, Copyright 2009, Ingenix, Inc.; the Physician ICD-9-CM 2010, Volumes 1 & 2, International Classification of Diseases, 9th Revision, Clinical Modification, Copyright 2009, Ingenix, Inc.
(3) The Current Dental Terminology (CDT-2009/2010), Copyright 2008, American Dental Association, and the HCPCS Level II, A resourceful complication of HCPCS codes 2010, 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) The ASC Reimbursement Manual is available for inspection during normal business hours at the Florida Department of Financial Services, Document Processing Section, 200 East Gaines Street, Tallahassee, Florida 32399-0311, or via the Department�s web site at http://www.myfloridacfo.com/wc/provider/reimbursement-manuals.html.
Rulemaking Authority 440.13(4), (14), 440.591 FS. Law Implemented 440.13(7), (12), (14) 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.