Tenn. Comp. R. & Regs. 0800-02-17-.09 - INDEPENDENT MEDICAL EXAMINATION TO EVALUATE MEDICAL ASPECTS OF A CASE

(1) An Independent Medical Examination ("IME"), performed to evaluate the medical aspects of a case (other than one conducted under the Bureau's MIRR Program), shall be billed using state-specific codes and shall include the practitioner's time only. Time spent shall include the office visit (face-to-face time with the patient), time spent reviewing records, reports and studies, and time spent preparing reports. State-specific code Z0610 shall be used to bill the first hour (shall not exceed $500). State-specific code Z0611 shall be used to bill each additional half hour (shall not exceed $250 per half hour). State-specific code Z0310-Impairment Rating (Form Completion) shall not be billed for IME services or in combination with codes Z0610 and Z0611, see 0800-02-17-.25.

(2) Prepayment for an Independent Medical Examination shall not exceed $500.

(3) Any laboratory procedure, x-ray procedure, and any other test which is needed to establish the worker's ability to return to work shall be identified by the appropriate procedure code established by this rule and reimbursed accordingly.

Notes

Tenn. Comp. R. & Regs. 0800-02-17-.09

Public necessity rule filed June 5, 2005; effective through November 27, 2005. Public necessity rule filed November 16, 2005; effective through April 30, 2006. Original rule filed February 3, 2006; effective April 19, 2006. Amendments filed March 12, 2012; to have been effective June 10, 2012. The Government Operations Committee filed a stay on May 7, 2012; new effective date August 9, 2012. Repeal and new rules filed November 27, 2017; effective February 25, 2018. Amendments filed June 12, 2019; effective September 10, 2019. Administrative changes made to this chapter on September 10, 2019; "Tennessee Workers' Compensation Act" or "Act" references were changed to "Tennessee Workers' Compensation Law" or "Law." Amendments filed June 28, 2021; effective September 26, 2021. Amendments filed June 27, 2023; effective 9/25/2023.

Authority: T.C.A. §§ 50-6-204, 50-6-205, and 50-6-233 (Repl. 2005).