Nev. Admin. Code § 616C.141

Current through December 12, 2024
Section 616C.141 - Requirements for programs of treatment billed under certain codes; use of codes in billing; contents of bills for certain office visits
1. If a program of treatment that is required to be billed under codes 97001 to 97799, inclusive, or 98925 to 98943, inclusive, is administered to an injured employee, the treatment, evaluation, manipulation, modality, mobilization procedure, testing or measurements must be administered by:
(a) A licensed physical therapist;
(b) A licensed physical therapist's assistant;
(c) A licensed occupational therapist;
(d) A licensed occupational therapy assistant;
(e) A licensed physician;
(f) A licensed chiropractor; or
(g) A certified chiropractor's assistant,

who is acting within the authorized scope of his or her license or certification.

2. If a treating physician or chiropractor prescribes a program of treatment that is required to be billed under codes 97010 to 97799, inclusive, or 98925 to 98943, inclusive, it must be in writing and include:
(a) A recommendation of the modalities or procedures, or both, to be administered to specific areas of the body; and
(b) The frequency of the treatments.
3. A provider of health care shall indicate on a bill presented to an insurer for any treatment each code contained in the Relative Values for Physicians, as adopted by reference pursuant to NAC 616C.145, or the Relative Value Guide of the American Society of Anesthesiologists, as adopted by reference pursuant to NAC 616C.146, for any services. The codes must be indicated on each bill regardless of whether the provisions of NAC 616C.070 to 616C.336, inclusive, allow for the payment of the services, the payment is requested or the item is included under a different code.
4. Any bill for an office visit that is billed under codes 90000 to 99999, inclusive, must include a written report concerning the history of the injured employee, a comprehensive evaluation of the injured employee's health condition or an evaluation of specific health problems of the injured employee, any decision made concerning the treatment required by the injured employee and all forms for submitting a claim to the insurer or billing reports that are requested by an insurer. Such a bill is not required to include a special report that is specifically requested by an insurer and is required to be billed under code 99080.

Nev. Admin. Code § 616C.141

Industrial Comm'n, No. 14.051, eff. 6-30-82-NAC A by Div. of Industrial Insurance Regulation, 10-26-83; 2-22-88; A by Dep't of Industrial Relations, 8-30-91; A by Div. of Industrial Relations, 10-11-93; 3-5-96; R121-97, 12-10-97, eff. 1-1-98; R090-99, 10-28-99; R105-00, 1-18-2001, eff. 3-1-2001; R118-02, 9-7-2005

NRS 616A.400, 616C.250, 616C.260