Colorado |
Issue | 19 |
---|---|
Volume | 45 |
Published | October 10, 2022 |
Final Rule |
Department of Labor and Employment |
Division of Workers' Compensation |
Attorney General | ||
1300 Broadway, 10th floor | ||
Denver, CO 80203 | ||
Chief Deputy Attorney General | Phone 720-508-6000 | |
Solicitor General | STATE OF COLORADO | |
DEPARTMENT OF LAW |
Tracking Number: |
The above-referenced rules were submitted to this office on 09/12/2022 as required by section 24-4-103, C.R.S. This office has reviewed them and finds no apparent constitutional or legal deficiency in their form or substance. |
Rule 16 | WORKERS' COMPENSATION RULES OF PROCEDUREUTILIZATION STANDARDS | |
16-1 | STATEMENT OF PURPOSE | 3 |
16-2 | STANDARD TERMINOLOGY FOR RULES 16, 17, AND 18 | 3 |
16-3 | GENERAL REQUIREMENTS | 6 |
16-4 | OUT-OF-STATE PROVIDERS | 7 |
16-5 | REQUIRED USE OF THE MEDICAL TREATMENT GUIDELINES | 7 |
16-6 | NOTIFICATION TO TREAT | 7 |
16-7 | PRIOR AUTHORIZATION | 8 |
16-7-1 | PRIOR AUTHORIZATION DENIALS | 9 |
16-7-2 | PRIOR AUTHORIZATION APPEALS | 10 |
16-8 | REQUIRED USE OF THE FEE SCHEDULE | 11 |
16-8-1 | REQUIRED BILLING FORMS AND CODES | 11 |
16-8-2 | TIMELY FILING | 12 |
16-9 | REQUIRED MEDICAL RECORD DOCUMENTATION | 13 |
16-10 | PAYMENT REQUIREMENTS FOR MEDICAL BILLS | 14 |
16-10-1 | MODIFIED, UNLISTED, AND UNPRICED CODES | 15 |
16-10-2 | DENYING PAYMENT OF BILLED TREATMENT FOR NON-MEDICAL REASONS | 16 |
16-10-3 | DENYING PAYMENT OF BILLED TREATMENT FOR MEDICAL REASONS | 16 |