Volume 17

17 Fla. L. Weekly Supp. 1241a

Online Reference: FLWSUPP 1712FAVOInsurance — 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. 1240a

Online Reference: FLWSUPP 1712NRAMInsurance — 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. 1239a

Online Reference: FLWSUPP 1712OLIVInsurance — 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. 1238a

Online Reference: FLWSUPP 1712HERNInsurance — 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. 1237a

Online Reference: FLWSUPP 1712GOMEInsurance — 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. 590a

Online Reference: FLWSUPP 1707LOBIInsurance — Personal injury protection — Coverage — Medical expenses — CPT coding — Insurer cannot deny payment for CPT code recognizable under Medicare Part B fee schedule on grounds that Medicare’s National Correct Coding Initiative provides that code 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. 589b

Online Reference: FLWSUPP 1707CAPOInsurance — Personal injury protection — Coverage — Medical expenses — CPT coding — Insurer cannot deny payment for CPT code recognizable under Medicare Part B fee schedule on grounds that Medicare’s National Correct Coding Initiative provides that code 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. 137a

Online Reference: FLWSUPP 1702ADVAInsurance — Personal injury protection — Coverage — Medicare Part B fee schedule — Where Medicare fee schedule entirely excludes payment for medically necessary service, insurer is nonetheless obligated to pay for that service by use of other fee determinations provided by PIP law, such as usual and customary charges or workers’ compensation fee schedule

17 Fla. L. Weekly Supp. 384a

Online Reference: FLWSUPP 1705LEIInsurance — Personal injury protection — Coverage — Medical expenses — CPT codes — Neuromuscular reeducation — Massage therapy — Unbundling — Insurer cannot deny payment for CPT codes for neuromuscular reeducation and massage therapy recognizable under Medicare Part B fee schedule on grounds that Medicare’s National Correct Coding Initiative provides that neuromuscular reeducation and massage therapy codes cannot be billed on same day as another code billed by medical provider where insurer did not assert affirmative defense of unbundling, and 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. 383b

Online Reference: FLWSUPP 1705TORRInsurance — Personal injury protection — Coverage — Medical expenses — CPT codes — Myofacial release — Massage therapy — Unbundling — Insurer cannot deny payment for CPT codes for myofacial release and massage therapy recognizable under Medicare Part B fee schedule on grounds that Medicare’s National Correct Coding Initiative provides that myofacial release and massage therapy codes cannot be billed on same day as each other and myofacial release code cannot be billed on same day as another code billed by medical provider where insurer did not assert affirmative defense of unbundling, and PIP statute forbids insurer from applying utilization limits — No merit to argument that NCCI is payment limitation rather than utilization limitation