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Rule Title: DISALLOWED PROCEDURES
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Department: LABOR AND INDUSTRY
Chapter: WORKERS' COMPENSATION AND OCCUPATIONAL DISEASE
Subchapter: Nonfacility Service Rules and Utilization Rules
 
Latest version of the adopted rule presented in Administrative Rules of Montana (ARM):

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24.29.1526    DISALLOWED PROCEDURES

(1) Only reasonable and necessary medical expenses are payable. Procedures that are not generally accepted by the medical community may be determined not to be "reasonable" or "necessary". Providers are encouraged to seek prior approval from the insurer for experimental or controversial procedures.

(2) Disputes arising over payment of medical services may be appealed pursuant to 39-71-704, MCA and, when applicable ARM 24.29.1404.

(3) Medical services which are not payable include, but are not limited to, the following:

(a) disc nucleoplasty;

(b) extreme lateral interbody fusion (XLIA);

(c) freezeframer;

(d) frequency specific microcurrent;

(e) HEALOS/leopard cage;

(f) inter X therapy;

(g) kinesis myofascial integration;

(h) lidoderm patch;

(i) percutaneous disc nucleoplasty; and

(j) medical marijuana.

History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 1993 MAR p. 404, Eff. 4/1/93; AMD, 2003 MAR p. 2870, Eff. 12/25/03; AMD, 2011 MAR p. 1137, Eff. 6/24/11.


 

 
MAR Notices Effective From Effective To History Notes
24-29-256 6/24/2011 Current History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 1993 MAR p. 404, Eff. 4/1/93; AMD, 2003 MAR p. 2870, Eff. 12/25/03; AMD, 2011 MAR p. 1137, Eff. 6/24/11.
12/25/2003 6/24/2011 History: 39-71-203, MCA; IMP, 39-71-704, MCA; NEW, 1993 MAR p. 404, Eff. 4/1/93; AMD, 2003 MAR p. 2870, Eff. 12/25/03.
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