Indiana § 16-51-1-7 "Institutional provider form"

Indiana Statutes

§ 16-51-1-7 — "Institutional provider form"

Indiana·Title 16 HEALTH·Art. 51 HEALTH CARE REQUIREMENTS·Ch. 1 Health Care Billing

(a)As used in this chapter, "institutional provider form" means a medical claim form that:

(1)is accepted by the federal Centers for Medicare and Medicaid Services for use by institutional providers; and

(2)does not include a claim field for disclosure of the site at which the health care services to which the form relates were provided.

(b)The term includes the following:

(1)The HIPAA X12 837I institutional form or its successor form.

(2)The CMS-1450 form or its successor form.

(3)The UB-04 form or its successor form.

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(a) As used in this chapter, "institutional
provider form" means a medical claim form that:
(1) is accepted by the federal Centers for Medicare and Medicaid
Services for use by institutional providers; and
(2) does not include a claim field for disclosure of the site at
which the health care services to which the form relates were
provided.
(b) The term includes the following:
(1) The HIPAA X12 837I institutional form or its successor form.
(2) The CMS-1450 form or its successor form.
(3) The UB-04 form or its successor form.

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