R 418.101503 Laboratory procedure codes and maximum allowable payments.

Rule 1503. (1) The workers' compensation agency shall determine the maximum allowable payment for the laboratory procedure codes found in the CPT and HCPCS codebooks, as adopted by reference in R418.10107. The rate shall be determined by multiplying the Medicare rate established for this state by 110%. (2) The pathology procedure codes found in the 80000 series of the CPT code set have assigned relative values and shall be provided on the agency’s website at www.michigan.gov/wca. (3) The maximum allowable payments for the laboratory and pathology procedures shall be provided on the agency’s website, www.michigan.gov/wca. (4) A provider performing drug testing, drug screening, and drug confirmation testing shall use the appropriate procedure codes G0480-G0483, G0659, or 80305-80307 listed in the HCPCS or CPT codebook, as adopted by reference in R418.10107. A maximum of one service unit per procedure code per date of service shall be billed with these codes.