WSR 07-10-104

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Health and Recovery Services Administration)

[ Filed May 1, 2007, 3:56 p.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 06-22-054.

Title of Rule and Other Identifying Information: Part 1 of 3; amending WAC 388-550-1200 Restrictions on hospital coverage, 388-550-1300 Revenue code categories and subcategories, 388-550-1350 Revenue code categories and subcategories -- CPT and HCPCS reporting requirements for outpatient hospitals, and 388-550-1400 Covered and noncovered revenue code categories and subcategories for inpatient hospital services.

Hearing Location(s): Blake Office Park East, Rose Room, 4500 10th Avenue S.E., Lacey, WA 98503 (one block north of the intersection of Pacific Avenue S.E. and Alhadeff Lane. A map or directions are available at http://www1.dshs.wa.gov/msa/rpau/docket.html or by calling (360) 664-6097), on June 5, 2007, at 10:00 a.m.

Date of Intended Adoption: Not earlier than June 6, 2007.

Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, delivery 4500 10th Avenue S.E., Lacey, WA 98503, e-mail schilse@dshs.wa.gov, fax (360) 664-6185, by 5:00 p.m. on June 5, 2007.

Assistance for Persons with Disabilities: Contact Stephanie Schiller by June 1, 2007, TTY (360) 664-6178 or (360) 664-6097 or by e-mail at schilse@dshs.wa.gov.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The department is proposing to amend sections in chapter 388-550 WAC relating to restrictions on hospital coverage, revenue code categories and subcategories for outpatient hospitals and inpatient hospital services for dates of admission before August 1, 2007, and on and after August 1, 2007. The department is also amending these sections in order to change verbiage from "medical assistance administration (MAA)" to "the department," change verbiage from "facility" to "hospital" and to update and clarify other language.

Reasons Supporting Proposal: See above.

Statutory Authority for Adoption: RCW 74.08.090 and 74.09.500.

Statute Being Implemented: RCW 74.08.090 and 74.09.500.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Department of social and health services, governmental.

Name of Agency Personnel Responsible for Drafting: Kathy Sayre, P.O. Box 45504, Olympia, WA 98504-5504, (360) 725-1342; Implementation and Enforcement: Larry Linn, P.O. Box 45502, Olympia, WA 98504-5502, (360) 725-1856.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The department has determined that the proposed rule will not create more than minor costs for affected small businesses.

A cost-benefit analysis is not required under RCW 34.05.328. The department has determined that the proposed rule does not meet the definition of "significant legislative rule" under RCW 34.05.328, and therefore a cost-benefit analysis is not required.

April 27, 2007

Stephanie E. Schiller

Rules Coordinator

3849.2
AMENDATORY SECTION(Amending WSR 99-06-046, filed 2/26/99, effective 3/29/99)

WAC 388-550-1200   ((Limitations)) Restrictions on hospital coverage.   A hospital ((coverage)) covered service provided to a client eligible under ((the)) a medical assistance ((fee for service)) program ((is limited for certain eligible clients)) that is paid by the department's fee-for-services payment system must be within the scope of the client's medical assistance program. ((This)) Coverage restriction includes, but is not limited to the following:

(1) ((Medical care)) Clients enrolled with the department's ((healthy options carriers)) managed care organization (MCO) plans are subject to the respective ((carrier's)) plan's policies and procedures for coverage of hospital services;

(2) ((Medical care)) Clients covered by primary care case management are subject to the clients' primary care physicians' approval for hospital services;

(3) For emergency care exemptions for clients described in subsections (1) and (2) ((and (3))) of this section, see WAC 388-538-100.

(4) Coverage for ((medically)) psychiatric indigent (((MI))) inpatient (PII) clients is limited to ((emergent)) voluntary inpatient psychiatric hospital services, subject to the conditions and limitations of WAC ((388-521-2140, 388-529-2950,)) 388-865-0217 and this chapter:

(a) Out-of-state ((care,)) healthcare ((hospital or other medical,)) is not covered for clients under the ((MI)) PII program; and

(b) Bordering city hospitals and critical border hospitals ((areas)) are not considered ((in-state)) instate hospitals for PII program claims.

(5) ((Out-of-state medical care is)) Healthcare services provided by a hospital located out-of-state are:

(a) Not covered for clients eligible under the medical care services (MCS) program. However, clients eligible for MCS are covered for that program's scope of care in bordering city and critical border hospitals.

(b) Covered for:

(i) Emergency care for eligible medicaid and SCHIP clients without prior authorization, based on the medical necessity and utilization review standards and limits established by the department.

(ii) Nonemergency out-of-state care for medicaid and SCHIP clients when prior authorized by the department based on the medical necessity and utilization review standards and limits.

(iii) Hospitals in bordering cities and critical border hospitals, based on the same client eligibility criteria and authorization policies as for instate hospitals. See WAC 388-501-0175 for a list of bordering cities.

(c) Covered for out-of-state voluntary inpatient psychiatric hospital services for eligible medicaid and SCHIP clients based on authorization by a mental health division (MHD) designee.

(6) See WAC 388-550-1100(((3))) for ((chemical-dependent pregnant clients)) hospital services for chemical-using pregnant (CUP) women.

(7) ((Only Medicaid categorically needy and medically needy clients under twenty-one years of age, or sixty-five years of age or older may receive care in a state mental institution or approved psychiatric facility)) All psychiatric inpatient hospital admissions, length of stay extensions, and transfers must be prior authorized by a MHD designee. See WAC 388-550-2600.

(8)(((a))) For clients eligible for both medicare and medicaid ((hospitalization)) (dual eligibles), ((MAA)) the department pays deductibles and coinsurance, unless the client has exhausted his or her medicare Part A benefits.

(((i) MAA payment is limited in amount so that when added to the Medicare payment, the total amount is no more than what the department pays for the same service when provided to a Medicaid eligible, non-Medicare client.

(ii) Providers must accept the total Medicare/Medicaid amount as payment in full.

(iii) Beneficiaries are not liable for any additional charges billed by providers or by a managed care entity.

(iv) Providers or managed care entities that charge beneficiaries excess amounts are subject to sanctions.

(b))) If ((such)) medicare benefits are exhausted, the department pays for hospitalization for such clients subject to ((MAA)) department rules. See also chapter 388-502 WAC.

(9) The department does not pay for covered inpatient hospital services for a medical assistance client:

(a) Who is discharged from a hospital by a physician because the client no longer meets medical necessity for acute inpatient level of care; and

(b) Who chooses to stay in the hospital beyond the period of medical necessity.

(10) If the hospital's utilization review committee determines the client's stay is beyond the period of medical necessity, as described in subsection (9) of this section, the hospital must:

(a) Inform the client in a written notice that the department is not responsible for payment (42 CFR 456);

(b) Comply with the requirements in WAC 388-502-0160 in order to bill the client for the service(s); and

(c) Send a copy of the written notice in (a) of this subsection to the department.

(11) Other coverage restrictions, as determined by the department.

[Statutory Authority: RCW 74.08.090, 42 USC 1395 x(v), 42 CFR 447.271, 447.11303, and 447.2652. 99-06-046, 388-550-1200, filed 2/26/99, effective 3/29/99. Statutory Authority: RCW 74.08.090, 74.09.730, 74.04.050, 70.01.010, 74.09.200, [74.09.]500, [74.09.]530 and 43.20B.020. 98-01-124, 388-550-1200, filed 12/18/97, effective 1/18/98.]


AMENDATORY SECTION(Amending WSR 03-19-044, filed 9/10/03, effective 10/11/03)

WAC 388-550-1300   Revenue code categories and subcategories.   (1) Revenue code categories and subcategories listed in this chapter are published in the UB-92 and/or UB-04 National Uniform Billing Data Element Specifications Manual.

(2) The ((medical assistance administration (MAA))) department requires a hospital provider to report and bill all hospital services provided to medical assistance clients using the appropriate revenue codes published in the manual referenced in subsection (1) of this section.

[Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, and Public Law 104-191. 03-19-044, 388-550-1300, filed 9/10/03, effective 10/11/03. Statutory Authority: RCW 74.08.090, 74.09.730, 74.04.050, 70.01.010, 74.09.200, [74.09.]500, [74.09.]530 and 43.20B.020. 98-01-124, 388-550-1300, filed 12/18/97, effective 1/18/98.]


AMENDATORY SECTION(Amending WSR 03-19-044, filed 9/10/03, effective 10/11/03)

WAC 388-550-1350   Revenue code categories and subcategories -- CPT and HCPCS reporting requirements for outpatient hospitals.   (1) The ((medical assistance administration (MAA))) department requires an outpatient hospital provider to report the appropriate current procedural terminology (CPT) or healthcare common procedure coding system (HCPCS) codes in addition to the required revenue codes on an outpatient claim line ((with)) when using any of the following revenue code categories and subcategories:

(a) "IV therapy," only ((subcategory)) subcategories "general classification" and "infusion pump";

(b) "Medical/surgical supplies and devices," only subcategory (("prosthetic/orthotic devices")) "other supplies/devices";

(c) "Oncology";

(d) "Laboratory";

(((d))) (e) "Laboratory pathological";

(((e))) (f) "Radiology - diagnostic";

(((f))) (g) "Radiology - therapeutic and/or chemotherapy administration";

(((g))) (h) "Nuclear medicine";

(((h))) (i) "CT scan";

(((i))) (j) "Operating room services," only subcategories "general classification" and "minor surgery";

(((j))) (k) "Blood and blood components";

(l) Administration, processing, and storage((,)) for blood components" ((only subcategory "administration (e.g., transfusions)"));

(((k))) (m) "Other imaging services";

(((l))) (n) "Respiratory services";

(((m))) (o) "Physical therapy";

(((n))) (p) "Occupational therapy";

(((o))) (q) "Speech therapy - language pathology";

(((p))) (r) "Emergency room," only subcategories "general classification" and "urgent care";

(((q))) (s) "Pulmonary function";

(((r))) (t) "Audiology";

(((s))) (u) "Cardiology";

(((t))) (v) "Ambulatory surgical care";

(((u) "Outpatient services";

(v))) (w) "Clinic," only subcategories "general classification((,))" (("dental clinic,")) and "other clinic";

(((w))) (x) "Magnetic resonance technology (MRT)";

(((x))) (y) "Medical/surgical supplies - extension," only subcategory "surgical dressings";

(((y))) (z) "Pharmacy - extension" subcategories "Erythropoietin (EPO) less than ten thousand units," "Erythropoietin (EPO) ten thousand or more units," "drugs requiring detailed coding," and "self-administrable drugs";

(((z))) (aa) "Labor room/delivery," only subcategories "general classification," "labor," "delivery," and "birthing center";

(((aa))) (bb) "EKG/ECG (electrocardiogram)";

(((bb))) (cc) "EEG (electroencephalogram)";

(((cc))) (dd) "Gastro-intestinal services";

(((dd))) (ee) "Specialty room - treatment/observation room," subcategory "treatment room and observation room";

(((ee) "Lithotripsy";))

(ff) "Telemedicine," only subcategory "other telemedicine";

(gg) "Extra-corporeal shock wave therapy (formerly lithotripsy)";

(hh) "Acquisition of body components," only subcategories "((living donor)) general classification" and "cadaver donor";

(((gg))) (ii) "Hemodialysis - outpatient or home," only subcategory "general classification";

(((hh))) (jj) "Peritoneal dialysis - outpatient or home," only subcategory "general classification";

(((ii))) (kk) "Continuous ambulatory peritoneal dialysis (CAPD) - outpatient or home," only subcategory "general classification";

(((jj))) (ll) "Continuous cycling peritoneal dialysis (CCPD) - outpatient or home," only subcategory "general classification";

(((kk))) (mm) "Miscellaneous dialysis," only subcategories "general classification" and "ultrafiltration";

(nn) "Behavioral health treatments/services," only subcategory "electroshock therapy";

(((ll) "Psychiatric/psychological treatments," only subcategory "electroshock therapy";

(mm))) (oo) "Other diagnostic services";

(((nn))) (pp) "Other therapeutic services," only ((subcategory)) subcategories "general classification," "cardiac rehabilitation," and "other therapeutic service"; and

(((oo))) (qq) Other revenue code categories and subcategories identified and published by the department.

(2) For an outpatient claim line requiring a CPT or HCPCS code(s), the department denies payment if the required code is not reported on the line.

[Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, and Public Law 104-191. 03-19-044, 388-550-1350, filed 9/10/03, effective 10/11/03.]


AMENDATORY SECTION(Amending WSR 03-19-045, filed 9/10/03, effective 10/11/03)

WAC 388-550-1400   Covered and noncovered revenue codes categories and subcategories for inpatient hospital services.   Subject to the limitations and restrictions listed, this section identifies covered and noncovered revenue code categories and subcategories for inpatient hospital services.

(1) The department ((covers)) pays for an inpatient hospital covered service in the following revenue code categories and subcategories ((for inpatient hospital services)) when the hospital provider accurately bills:

(a) "Room & board - private (one bed)," only subcategories "general classification," "medical/surgical/gyn," "OB," "pediatric," and "oncology";

(b) "Room & board - semi-private (two bed)," only subcategories "general classification," "medical/surgical/gyn," "OB," "pediatric," and "oncology";

(c) "Room & board - semi-private - (three and four beds)," only subcategories "general classification," "medical/surgical/gyn," "OB," "pediatric," and "oncology";

(d) "Room & board - deluxe private (((deluxe)))," only subcategories "general classification," "medical/surgical/gyn," "OB," "pediatric," and "oncology";

(e) "Nursery," only subcategories "general classification," "newborn - level I," "newborn - level II," "newborn - level III," and "newborn - level IV";

(f) "Intensive care unit," only subcategories "general classification," "surgical," "medical," "pediatric," "intermediate ICU," "burn care," and "trauma";

(g) "Coronary care unit," only subcategories "general classification," "myocardial infarction," "pulmonary care," and "intermediate CCU";

(h) "Pharmacy," only subcategories "general classification," "generic drugs," "nongeneric drugs," "drugs incident to other diagnostic services," "drugs incident to radiology," "nonprescription," and "IV solutions";

(i) "IV therapy," only subcategories "general classification," "infusion pump," "IV therapy/pharmacy services," "IV therapy/drug/supply delivery" and "IV therapy/supplies";

(j) "Medical/surgical supplies and devices," only subcategories "general classification," "nonsterile supply," "sterile supply," "pacemaker," "intraocular lens," and "other implant";

(k) "Oncology," only subcategory "general classification";

(l) "Laboratory," only subcategories "general classification," "chemistry," "immunology," "nonroutine dialysis," "hematology," "bacteriology & microbiology," and "urology";

(m) "Laboratory ((pathological)) pathology," only subcategories "general classification," "cytology," "histology," and "biopsy";

(n) "Radiology - diagnostic," only subcategories "general classification," "angiocardiography," "arthrography," "arteriography," and "chest X ray";

(o) "Radiology - therapeutic and/or chemotherapy administration," only subcategories "general classification," "chemotherapy administration - injected," "chemotherapy administration - oral," "radiation therapy," and "chemotherapy administration - IV";

(p) "Nuclear medicine," only subcategories "general classification," "diagnostic," ((and)) "therapeutic," "diagnostic radiopharmaceuticals," and "therapeutic radiopharmaceuticals";

(q) "CT scan," only subcategories "general classification," "head scan," and "body scan";

(r) "Operating room services," only subcategories "general classification" and "minor surgery";

(s) "Anesthesia," only subcategories "general classification," "anesthesia incident to radiology," and "anesthesia incident to other diagnostic services";

(t) "((Blood and blood component)) Administration, processing and storage for blood and blood component," only subcategories "general classification" and "administration (((e.g., transfusions)))";

(u) "Other imaging services," only subcategories "general classification," "diagnostic mammography," "ultrasound," and "positron emission tomography";

(v) "Respiratory services," only subcategories "general classification," "inhalation services" and "hyper baric oxygen therapy";

(w) "Physical therapy," only subcategories "general classification," "visit charge," "hourly charge," "group rate," and "evaluation or reevaluation";

(x) "Speech therapy-language pathology," only subcategories "general classification," "visit charge," "hourly charge," "group rate," and "evaluation or reevaluation";

(y) "Emergency room," only subcategories "general, urgent care classification" and "urgent care";

(z) "Pulmonary function," only subcategory "general classification";

(aa) "Cardiology," only subcategories "general classification," "cardiac cath lab," "stress test," and "echocardiology";

(bb) "Ambulatory surgical care," only subcategory "general classification";

(cc) "Outpatient services," only subcategory "general classification";

(dd) "Magnetic resonance technology (MRT)," only subcategories "general classification," "MRI - brain (including brainstem)," "MRI - spinal cord (including spine)," "MRI - other," "MRA - head and neck," ((and)) "MRA - lower extremities," and "MRA-other";

(ee) "Medical/surgical supplies - extension," only subcategories "supplies incident to radiology," "supplies incident to other diagnostic services," and "surgical dressings";

(ff) "Pharmacy-extension," only subcategories "single source drug," "multiple source drug," "restrictive prescription," "erythropoietin (EPO) less than ten thousand units," "erythropoietin (EPO) ten thousand or more units," "drugs requiring detailed coding," and "self-administrable drugs";

(gg) "Cast room," only subcategory "general classification";

(hh) "Recovery room," only subcategory "general classification";

(ii) "Labor room/delivery," only subcategory "general

classification," "labor," "delivery," and "birthing center";

(jj) "EKG/ECG (Electrocardiogram)," only subcategories "general classification," "holter monitor," and "telemetry";

(kk) "EEG (Electroencephalogram)," only subcategory "general classification";

(ll) "Gastro-intestinal services," only subcategory "general classification";

(mm) "Treatment/observation room," only subcategories "general classification," "treatment room," and "observation room";

(nn) (("Lithotripsy," only subcategory "general classification")) "Extra-corporeal shock wave therapy (formerly lithotripsy)," only subcategory "general classification";

(oo) "Inpatient renal dialysis," only subcategories "general classification," "inpatient hemodialysis," "inpatient peritoneal (non-CAPD)," "inpatient continuous ambulatory peritoneal dialysis (CAPD)," and "inpatient continuous cycling peritoneal dialysis (CCPD)";

(pp) "Acquisition of body components," only subcategories "general classification," "living donor," and "cadaver donor";

(qq) "Miscellaneous dialysis," only subcategory "ultra filtration((,))" ((and));

(rr) "Other diagnostic services," only subcategories "general classification," "peripheral vascularlab," "electromyelogram," and "pregnancy test((.))"; and

(ss) "Other therapeutic services," only subcategory "general classification".

(2) The department ((covers)) pays for an inpatient hospital covered service in the following revenue code subcategories ((for inpatient hospital services)) only when the hospital provider is approved by the department to provide the specific service(((s))):

(a) "All inclusive rate," only subcategory "all-inclusive room & board plus ancillary";

(b) "Room & board - private (one bed)," only subcategory "psychiatric";

(c) "Room & board - semi-private (two beds)," only subcategories "psychiatric," "detoxification," "rehabilitation," and "other";

(d) "Room & board - semi-private three and four beds," only subcategories "psychiatric" and "detoxification";

(e) "Room & board - deluxe private (((deluxe)))," only subcategory "psychiatric";

(f) "Room & board - ward," only subcategories "general classification" and "detoxification";

(g) "Room & board - other," only subcategories "general classification" and "other";

(h) "Intensive care unit," only subcategory "psychiatric";

(i) "Coronary care unit," only subcategory "heart transplant";

(j) "Operating room services," only subcategories "organ transplant-other than kidney" and "kidney transplant";

(k) "Occupational therapy," only subcategories "general classification," "visit charge," "hourly charge," "group rate" and "evaluation or reevaluation";

(l) "Clinic," only subcategory "chronic pain clinic";

(m) "Ambulance," only subcategory "neonatal ambulance services";

(n) "((Psychiatric/psychological treatments)) Behavioral health treatment/services," only subcategory "electroshock treatment"; and

(o) "((Psychiatric/psychological)) Behavioral health treatment/services - extension," only subcategory "rehabilitation."

(3) The department ((covers)) pays revenue code category "occupational therapy," subcategories "general classification, "visit charge, "hourly charge," "group rate," and "evaluation or reevaluation" when:

(a) A client is in an acute PM&R facility;

(b) A client is age twenty or younger; or

(c) The diagnosis code is listed in the ((medical assistance administration's (MAA's))) department's published billing instructions.

(4) The department does not ((cover)) pay for inpatient hospital services in the following revenue code categories and subcategories ((for inpatient hospital services)):

(a) "All inclusive rate," subcategory "all-inclusive room and board";

(b) "Room & board - private (one bed)" subcategories "hospice," "detoxification," "rehabilitation," and "other";

(c) "Room & board - semi-private (two bed)," subcategory "hospice";

(d) "Room & board - semi-private - (three and four beds)," subcategories "hospice," "rehabilitation," and "other";

(e) "Room & board - deluxe private (((deluxe)))," subcategories "hospice," "detoxification," "rehabilitation," and "other";

(f) "Room & board - ward," subcategories "medical/surgical/gyn," "OB," "pediatric," "psychiatric," "hospice," "oncology," "rehabilitation," and "other";

(g) "Room & board - other," subcategories "sterile environment," and "self care";

(h) "Nursery," subcategory "other nursery";

(i) "Leave of absence";

(j) "Subacute care";

(k) "Intensive care unit," subcategory "other intensive care";

(l) "Coronary care unit," subcategory "other coronary care";

(m) "Special charges";

(n) "Incremental nursing charge ((rate))";

(o) "All inclusive ancillary";

(p) "Pharmacy," subcategories "take home drugs," "experimental drugs," and "other pharmacy";

(q) "IV therapy," subcategory "other IV therapy";

(r) "Medical/surgical supplies and devices," subcategories "take home supplies," "prosthetic/orthotics devices," "oxygen - take home," and "other supplies/devices";

(s) "Oncology," subcategory "other oncology";

(t) "Durable medical equipment (other than renal)";

(u) "Laboratory," subcategories "renal patient (home)," and "other laboratory";

(v) "Laboratory ((pathological)) pathology," subcategory "other laboratory - pathological";

(w) "Radiology - diagnostic," subcategory "other radiology - diagnostic";

(x) "Radiology - therapeutic," subcategory "other radiology - therapeutic";

(y) "Nuclear medicine," subcategory "other nuclear medicine";

(z) "CT scan," subcategory "other CT scan";

(aa) "Operating room services," subcategory "other operating room services";

(bb) "Anesthesia," subcategories "acupuncture," and "other anesthesia";

(cc) "Blood and blood components";

(dd) "((Blood and blood component)) Administration, processing and storage for blood and blood components," subcategory "other processing and storage";

(ee) "Other imaging services," subcategories "screening mammography," and "other imaging services";

(ff) "Respiratory services," subcategory "other respiratory services";

(gg) "Physical therapy," subcategory "other physical therapy";

(hh) "Occupational therapy," subcategory "other occupational therapy";

(ii) "Speech therapy-language pathology," subcategory "other speech-language pathology";

(jj) "Emergency room," subcategories "EMTALA emergency medical screening services," "ER beyond EMTALA screening," and "other emergency room";

(kk) "Pulmonary function," subcategory "other pulmonary function";

(ll) "Audiology";

(mm) "Cardiology," subcategory "other cardiology";

(nn) "Ambulatory surgical care," subcategory "other ambulatory surgical care";

(oo) "Outpatient services," subcategory "other outpatient service";

(pp) "Clinic," subcategories "general classification," "dental clinic," "psychiatric clinic," "OB-gyn clinic," "pediatric clinic," "urgent care clinic," "family practice clinic," and "other clinic";

(qq) "Free-standing clinic";

(rr) "Osteopathic services";

(ss) "Ambulance," subcategories "general classification," "supplies," "medical transport," "heart mobile," "oxygen," "air ambulance," "pharmacy," "telephone transmission EKG," and "other ambulance";

(tt) "Home health (HH) skilled nursing";

(uu) "Home health (HH) medical social services";

(vv) "Home health (HH) - ((home health)) aide";

(ww) "Home health (HH) - other visits";

(xx) "Home health (HH) - units of service";

(yy) "Home health (HH) - oxygen";

(zz) "Magnetic resonance technology (MRT)," ((subcategories "MRA-other" and)) subcategory "other MRT";

(aaa) "Medical" "medical/surgical supplies - extension," subcategory "FDA investigational devices";

(bbb) "Home IV therapy services";

(ccc) "Hospice services";

(ddd) "Respite care";

(eee) "Outpatient special residence charges";

(fff) "Trauma response";

(ggg) "Cast room," subcategory "other cast room";

(hhh) "Recovery room," subcategory "other recovery room";

(iii) "Labor room/delivery," subcategories "circumcision" and "other labor room/delivery";

(jjj) "EKG/ECG (Electrocardiogram)," subcategory "other EKG/ECG";

(kkk) "EEG (Electroencephalogram)," subcategory "other EEG";

(lll) "Gastro-intestinal services," subcategory "other gastro-intestinal";

(mmm) "Specialty room - treatment/observation room," subcategory "other ((treatment/observation room)) speciality rooms";

(nnn) "Preventive care services";

(ooo) "Telemedicine";

(ppp) "((Lithotripsy," subcategory "other lithotripsy")) Extra-corporeal shock wave therapy (formerly lithotripsy)," subcategory "other ESWT";

(qqq) "Inpatient renal dialysis," subcategory "other inpatient dialysis";

(rrr) "Acquisition of body components," subcategories "unknown donor," "unsuccessful organ search - donor bank charges," and "other donor";

(sss) "Hemodialysis - outpatient or home";

(ttt) "Peritoneal dialysis - outpatient or home";

(uuu) "Continuous ambulatory peritoneal dialysis (CAPD) - outpatient or home";

(vvv) "Continuous cycling peritoneal dialysis (CCPD) - outpatient or home";

(www) "Miscellaneous dialysis," subcategories "general

classification," "home dialysis aid visit," and "other miscellaneous dialysis";

(xxx) (("Psychiatric/psychological treatments,")) Behavioral health treatments/services, subcategories "general classification," "milieu therapy," "play therapy," "activity therapy," ((and "other psychiatric/psychological treatment")) "intensive outpatient services - psychiatric," "intensive outpatient services - chemical dependency," "community behavioral health program (day treatment)";

(yyy) (("Psychiatric/psychological services,")) Behavioral health treatment/services - (extension), subcategories "((general classification)) rehabilitation," "partial hospitalization - less intensive," "partial hospitalization - intensive," "individual therapy," "group therapy," "family therapy," "bio feedback," "testing," and "other ((psychiatric/psychological service)) behavioral health treatment/services";

(zzz) "Other diagnostic services," subcategories "general classification," "pap smear," "allergy test," and "other diagnostic service";

(aaaa) "Medical rehabilitation day program";

(bbbb) "Other therapeutic services," subcategories "recreational therapy," "cardiac rehabilitation," "drug rehabilitation," "alcohol rehabilitation," "complex medical equipment - routine," "complex medical equipment - ancillary," and "other therapeutic services";

(cccc) "Other therapeutic services - extension," subcategories "athletic training" and "kinesiotherapy";

(dddd) "Professional fees";

(((dddd))) (eeee) "Patient convenience items"; and

(((eeee))) (ffff) Revenue code categories and subcategories that are not identified in this section.

[Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, and Public Law 104-191. 03-19-045, 388-550-1400, filed 9/10/03, effective 10/11/03. Statutory Authority: RCW 74.08.090. 01-02-075, 388-550-1400, filed 12/29/00, effective 1/29/01. Statutory Authority: RCW 74.08.090, 74.09.730, 74.04.050, 70.01.010, 74.09.200, [74.09.]500, [74.09.]530 and 43.20B.020. 98-01-124, 388-550-1400, filed 12/18/97, effective 1/18/98.]

Washington State Code Reviser's Office