Volume 17

17 Fla. L. Weekly Supp. 471b

Online Reference: FLWSUPP 1706VELEInsurance — Personal injury protection — Coverage — Medical expenses — CPT coding — Where medical provider improperly filed claim for CPT code for unbundled service, insurer properly paid benefits for simultaneously billed bundled service code that included denied unbundled service

17 Fla. L. Weekly Supp. 466a

Online Reference: FLWSUPP 1706BADIInsurance — Personal injury protection — Coverage — Medical expenses — CPT coding — National Correct Coding Initiative is incorporated in Florida PIP law as part of Medicare pay system — Where medical provider improperly filed claims for CPT codes for comprehensive treatments and unbundled component services, insurer was not required to contact provider before paying benefits for comprehensive treatments and denying benefits for component services, as this did not constitute change in coding — No merit to argument that, if bills were not payable under Medicare Part B due to unbundling, they should be paid under workers’ compensation fee schedule — Question certified

17 Fla. L. Weekly Supp. 28a

Online Reference: FLWSUPP 1701THOMInsurance — Personal injury protection — Coverage — Medical expenses — Insurer properly denied payment for CPT code presented without modifier indicating it was separate from and separately compensable from another comprehensive CPT code charged the same day and paid by insurer

17 Fla. L. Weekly Supp. 1247a

Online Reference: FLWSUPP 1712APONInsurance — Personal injury protection — Coverage — Medical expenses — National Correct Coding Initiative edits, which bar physicians from administering certain services to patient on same day, are utilization limitations prohibited by PIP statute

17 Fla. L. Weekly Supp. 1246a

Online Reference: FLWSUPP 1712ARROInsurance — Personal injury protection — Coverage — Medical expenses — National Correct Coding Initiative edits, which bar physicians from administering certain services to patient on same day, are utilization limitations prohibited by PIP statute

17 Fla. L. Weekly Supp. 1245a

Online Reference: FLWSUPP 1712BGOMInsurance — Personal injury protection — Coverage — Medical expenses — National Correct Coding Initiative edits, which bar physicians from administering certain services to patient on same day, are utilization limitations prohibited by PIP statute

17 Fla. L. Weekly Supp. 1244a

Online Reference: FLWSUPP 1712BRITInsurance — Personal injury protection — Coverage — Medical expenses — National Correct Coding Initiative edits, which bar physicians from administering certain services to patient on same day, are utilization limitations prohibited by PIP statute

17 Fla. L. Weekly Supp. 1243a

Online Reference: FLWSUPP 1712ALIInsurance — Personal injury protection — Coverage — Medical expenses — CPT coding — Unbundling — Insurer cannot deny payment for CPT codes recognizable under Medicare Part B fee schedule on grounds that Medicare’s National Correct Coding Initiative provides that codes cannot be billed on same day as each other where PIP statute forbids insurer from applying utilization limits — No merit to argument that NCCI is payment limitation rather than utilization limitation

17 Fla. L. Weekly Supp. 1242b

Online Reference: FLWSUPP 1712HOLMInsurance — Personal injury protection — Coverage — Medical expenses — CPT coding — Unbundling — Insurer cannot deny payment for CPT codes recognizable under Medicare Part B fee schedule on grounds that Medicare’s National Correct Coding Initiative provides that codes cannot be billed on same day as each other and cannot be billed on same day as another code billed by medical provider where PIP statute forbids insurer from applying utilization limits — No merit to argument that NCCI is payment limitation rather than utilization limitation

17 Fla. L. Weekly Supp. 1242a

Online Reference: FLWSUPP 1712ROSAInsurance — Personal injury protection — Coverage — Medical expenses — CPT coding — Unbundling — Insurer cannot deny payment for CPT codes recognizable under Medicare Part B fee schedule on grounds that Medicare’s National Correct Coding Initiative provides that codes cannot be billed on same day as each other and cannot be billed on same day as another code billed by medical provider where PIP statute forbids insurer from applying utilization limits — No merit to argument that NCCI is payment limitation rather than utilization limitation