18 Fla. L. Weekly Supp. 414a
Online Reference: FLWSUPP 1804GUER
Insurance — Personal injury protection — Coverage — Medical expenses — CPT coding — Affidavit of certified procedural coder which addresses propriety of medical provider’s coding fails to rebut treating physician’s affidavit as to sole remaining issue of reasonableness of charges — Summary judgment is entered in favor of medical provider
RONALD J. TRAPANA, M.D., P.A., a Florida Corporation, (assignee of Guerrier, Dieula) Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 17th Judicial Circuit in and for Broward County. Case No. 08-19430 COCE 53. February 17, 2011. Robert W. Lee, Judge. Counsel: Russel Lazega, Law Offices of Russel Lazega, P.A., D/B/A Florida Insurance Advocates, North Miami, for Plaintiff.
FINAL SUMMARY JUDGMENT INFAVOR OF THE PLAINTIFF
THIS CAUSE came before the Court for hearing on January 6, 2011 on Plaintiff’s Motion for Final Summary Judgment and, having reviewed the motions and entire Court file; heard argument; reviewed the relevant legal authorities; and been sufficiently advised in the premises, the Court finds as follows:
Background: This is a P.I.P. case brought by a provider seeking payment in the amount of $622.99 based on reductions and denials taken by the Defendant. The only codes at issue are CPT Codes 72100, 76140, 99204, and 97750. Plaintiff moves for final summary judgment on the issue of whether the charges of the services rendered by the Plaintiff were reasonable (pricing), which is the last remaining issue in this suit. The Plaintiff has filed the affidavit of the treating physician in support of its motion, which attests that the Plaintiff’s charges are reasonable and inline with the charges of other physicians performing the same services and are consistent with amounts authorized by other insurers. In opposition to the Plaintiff’s motion, Defendant has filed the Affidavit of Connie Coleman, who is asserted to be a Certified Procedural Coder.
Conclusion of Law: This Court finds that the Affidavit of Connie Coleman fails to rebut the Affidavit of the Plaintiff as it addresses the propriety of the Plaintiff’s coding and does not address whether the Plaintiff’s charges for treatment were reasonable in pricing, which is the sole remaining issue in this case.
Accordingly, final summary judgment is entered in favor of the Plaintiff.
The Plaintiff, Ronald J. Trapana, M.D., P.A., whose address is 4018 Sheridan Street, Hollywood, FL 33021, shall recover from the Defendant, State Farm Mutual Automobile Insurance Company, whose address is Post Office Box 9619, Winter Haven, FL 33883, the principal sum of $622.99 together with interest at the rate of 11% pursuant to F.S.s. 627.736(4) from April, 2008 to January 10, 2011 in the amount of $186.83.
This judgment shall bear post-judgment interest at the rate of 6% per year from date of entry until satisfied.
The draft shall be payable to Ronald J. Trapana, M.D., P.A. and delivered to Russel Lazega, Esq. at The Law Office of Russel Lazega, P.A., whose address is 13499 Biscayne Blvd, Suite 107, North Miami, FL 33181. Plaintiff is the prevailing party and is entitled to recover attorney’s fees and costs pursuant to F.S.s. 627.428.
The Court reserves jurisdiction to detelinine the reasonable amount of attorney’s fees and costs and enter judgment accordingly.
Let execution issue for the above sums.
