DATE: February 12, 2004
TO: All Interested Parties
FROM: Health Care Services Division
RE: 2004 Rules and Fee Updates
The 2004 Health Care Services Rules were filed with the office of the Secretary of State on 2/12/2004 and are effective February 20, 2004. The table below lists the rules that were changed this year. For 2004, CPT® has deleted the starred designation for the minor surgical procedures, therefore the manual no longer notes starred surgical procedures or the initial exam 99025, previously billed with the minor starred surgical procedures. Use the minor E/M service as appropriate.
Also, we want to notify you that workers' compensation is now known as the Workers' Compensation Agency and our agency is part of the Michigan Department of Labor & Economic Growth. The carriers should incorporate this information on the Carriers' Explanation of Benefits form.
SUMMARY OF RULE CHANGES FOR 2004
| R418.10106 |
Language for paying reasonable and necessary in sub (2) |
| R418.10107 |
Updates to 2004 CPT® and other source documents |
| R418.10109 |
Updates time span defining usual and customary |
|
R418.10202
|
Language to prevent billing review of x-rays separate from E-M
|
|
R418.10214
|
Places the fees for L codes in R 418.101504.
|
| R418.10901 |
Corrects typo in (3). Adds language re: payment to radiologists.
|
| R418.101002 |
Sets conversion factor at $47.77 for 2004 effective with date of rules
|
|
R418.101017
|
Technical change to delete Table 10924 as rule 924 deleted in 2003.
|
|
R418.101101
|
Corrected procedures in table 10916 to read 90801-90815 (not 990815).
|
|
R418.10922
|
Hospital ratios now will be published with effective date of these rules
|
| R418.101504 |
Removes deleted codes from the L-Code procedures. |
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