(1) Refer to WAC 296-20-010
regarding general rules and billing procedures.
(2) Refer to WAC 296-20-132
regarding the use of conversion factors.
(3) In addition to general rules found in WAC 296-20-010
, the following rules apply to naturopathic physicians:
(a) If the naturopathic physician is dual licensed, all treatment rendered by the practitioner must be billed as "treatment of the day." Further, the practitioner must elect and notify the department or self-insurer, which type of treatment he is providing for the injured worker, and abide by rules pertaining to area of elected treatment.
(b) Naturopathic physicians utilizing hydro-; mechano-; and/or electro-therapy modalities cannot bill for those services in addition to office visit services. Office visit includes treatment of the day.
(c) No more than one office visit will be allowed per day, except on the initial and next two subsequent visits. The attending doctor must submit a detailed report regarding the need for the additional treatment.
(d) If necessary, X rays may be taken immediately prior to and following the initial naturopathic physician treatment without prior authorization.
(e) X rays immediately prior to and following each subsequent naturopathic physician treatment will be disallowed, unless previously authorized.
(f) Prior authorization must be obtained for X rays subsequent to initial treatment.
(g) Payment will not be made for excessive or unnecessary X rays. No payment will be made for X rays taken on rejected or closed claims, except those taken in conjunction with a reopening application.
(h) See chapter 296-23
WAC for custody requirements for X rays.
(4) Drugless therapy as a maintenance or supportive measure will not be authorized or paid.
(5) Treatment beyond the first twenty treatments or sixty days, whichever occurs first, will not be authorized without submission of a consultation report or a comprehensive comparative exam report regarding need for further care.
[Statutory Authority: RCW 51.04.020, 51.04.030 and 1993 c 159. 93-16-072, § 296-23-205, filed 8/1/93, effective 9/1/93.]