053-10 Wyo. Code R. §§ 10-20 - Payment for Medical Services and Professional Fees

(a) Claims for medical services provided to an injured worker for a compensable injury, and any associated fees charged by professionals, will be denied if: they fail to comply with the following standards for content of medical records:
(i) If handwritten, medical notes must be legible to anyone reading them,
(ii) If handwritten notes are illegible, medical notes must be typewritten,
(iii) Medical notes must include date of patient visit,
(iv) Medical notes must specify the reason for the encounter/visit and be described using the injured worker's own words,
(v) Medical notes must include a history and physical exam focused relative to injured worker's complaint to include a description of the findings of the examine relating to the reason for the complaint,
(vi) Medical notes must specify the diagnosis relative to the injured worker presenting complaint,
(vii) Medical notes must delineate a course of treatment consistent with the diagnosis,
(viii) The studies ordered of the injured worker must pertain to the complaint being addressed,
(ix) Medical notes must delineate the education instruction to the injured worker,
(x) Medical notes must contain an indication of the specifics of the follow-up care plan and include return-to-work expectations.
(xi) Medical notes must include authentication by the treating provider that adhere to the following criteria:
(A) A signature and date by the treating provider shall constitute authentication.
(B) A signature shall include the treating provider's first and last name and appropriate credentials (i.e. "P.A.", "D.O.", or "M.D.").
(C) Electronic signatures may be accepted, provided the signature includes a date, timestamp, and a printed statement such as "electronically signed by" or "verified/reviewed by."
(D) Rubber stamps may be utilized in situations where the treating provider has a physical disability that prevents them from manually or electronically signing the documentation for authentication. By affixing the rubber stamp, the treating provider certifies their review of the document.

Notes

053-10 Wyo. Code R. §§ 10-20
Amended, Eff. 8/24/2017. Amended, Eff. 6/7/2019. Amended, Eff. 4/16/2020. Amended, Eff. 10/26/2020. Amended, Eff. 2/7/2023. Amended, Eff. 7/5/2023. Amended, Eff. 7/22/2024. Amended, Eff. 1/18/2025.

State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.


No prior version found.