MT001
This code is Montana specific and should be used for the following services:

• face to face conferences with payer representative(s) to update the status of a patient upon request of the payer;
•  a report associated with non-physician conferences required by the payer; or
• completion of a job description or job analysis requested by the payer.
• Written questions that require a written response from the provider, excluding the Medical Status Form.

Time must be documented in the submitted record, report or job analysis. The current RVU for MT001 is .54 per 15 minute unit.

99080 is not an appropriate code for reimbursement of the above services.

MT003
When requesting reimbursement for implants, MT003 is required to indicate that an outlier is being requested. The manufacturer’s invoice is required along with the operative report. Please do not whiteout the manufacturer information as it cannot be validated as a manufacturer’s invoice and is sometimes needed when verifying certain items in the operative record.

99211/INR’s
If an injured worker is being seen for a scheduled routine INR and no other services, 99211 would not be a payable service. If the nurse is providing other services not related to the INR but is related to the injury documentation must support the service.   Routine blood pressure checks and vital signs are not considered a separate service.

Bilateral Procedure Calculation Change
Calculation for bilateral procedures has changed slightly with the new rule that became effective July 1, 2014. Providers are instructed to bill all bilateral procedures with modifier 50 (see the Montana Professional Fee Schedule Instruction Set, page 6) on the Department of Labor & Industry website at http://mtwcfeeschedule.ingenix.com/documentations/ProfessionalFeeScheduleInstructionSet2014.pdf.