BEFORE THE DEPARTMENT OF LABOR AND INDUSTRY

OF THE STATE OF MONTANA

 

In the matter of the amendment of ARM 24.29.1433, 24.29.1534, and 24.29.1538 pertaining to workers' compensation facility service rules and rates and conversion factors

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NOTICE OF AMENDMENT

 

TO: All Concerned Persons

 

1. On March 30, 2018, the Department of Labor and Industry (department) published MAR Notice No. 24-29-335 regarding the public hearing on the proposed amendment of the above-stated rules, at page 613 of the 2018 Montana Administrative Register, Issue Number 6.

 

2. On April 20, 2018, a public hearing on the proposed amendment of the above-stated rules was held in Helena. Two comments were received during the public comment period.

 

3. The department has thoroughly considered the comments received. A summary of the comments, and the department responses, are as follows:

 

Comment 1: A commenter questioned a provision of the Professional Fee Schedule Instruction Set in Section Seven, Medicine, Subsection IV, Passive Therapy, in the second paragraph, regarding the correct usage of ICD-10 codes S13.110A – S13.180A, S23.110A – S23.170A, and S33.110A – S33.2xxA. The commenter questioned the use of the term "subluxation" in those contexts for coding and for treatment.

 

Response 1: As a result of comment, the department (in consultation with a Montana licensed chiropractor) agrees that the second paragraph is confusing and potentially misleading. The department will replace the second paragraph of that subsection in the publication with the following language:

 

            "Chiropractic care is a passive therapy per the Montana Utilization and Treatment Guidelines. The codes 98940-98943 are adjustment codes which will be given a 15-minute value for ease of calculating the total number of units. If there is a need for additional treatment beyond the manipulation code, the provider must append modifier 59 to 97140 and indicate the number of units. Documentation must be very clear on the additional treatment(s) and the expected outcomes. Code 97140-59 will be reviewed for appropriate usage when used on the same visit and code set 98940-98943."

 

Comment 2: A commenter questioned whether page 12 of the Facility Fee Schedule Instruction Set contained an error by showing that the base rate was a negative $8,373.00.

 

Response 2: The Facility Fee Schedule Instruction Set, on page 12, included a typographical error that showed a hyphen (-) in front of the base rate of $8,373.00. The hyphen has been removed from the publication. The base rate is $8,373.00, not a negative amount.

 

            4. The department has amended the above-stated rules as proposed. The 2018 fee schedules and instruction sets apply to services provided on or after July 1, 2018.

/s/ MARK CADWALLADER Mark Cadwallader Alternate Rule Reviewer	/s/ GALEN HOLLENBAUGH Galen Hollenbaugh, Commissioner DEPARTMENT OF LABOR AND INDUSTRY

 

            Certified to the Secretary of State May 15, 2018.