§ 27-8-10-11.2 — Use of diagnostic or procedure codes

Indiana § 27-8-10-11.2

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 8: LIFE, ACCIDENT, AND HEALTH
• Ch. 10: Comprehensive Health Insurance

Text

2. (a) Not more than ninety (90) days after
the date of the version specified in IC 27-1-1.5 of a diagnostic or
procedure code described in this subsection:
(1) the association shall begin using the version specified in IC 27-1-1.5 of the:
(A) Current Procedural Terminology (CPT);
(B) International Classification of Diseases (ICD);
(C) American Psychiatric Association's Diagnostic and
Statistical Manual of Mental Disorders (DSM);
(D) Current Dental Terminology (CDT);
(E) Healthcare Common Procedure Coding System (HCPCS);
and
(F) third party administrator (TPA);
codes under which the association pays claims for services
provided under an association policy; and
(2) a health care provider shall begin using the version specified
in IC 27-1-1.5 of the:
(A) Current Procedural Terminology (CPT);
(B) International Classification of Diseases (ICD);
(C) American Psychiatric Association's Diagnostic and
Statistical Manual of Mental Disorders (DSM);
(D) Current Dental Terminology (CDT);
(E) Healthcare Common Procedure Coding System (HCPCS);
and
(F) third party administrator (TPA);
codes under which the health care provider submits claims for
payment for services provided under an association policy.
(b) If a health care provider provides services that are covered under
an association policy:
(1) after the date of the version specified in IC 27-1-1.5 of a
diagnostic or procedure code described in subsection (a); and
(2) before the association begins using the version of the
diagnostic or procedure code;
the association shall reimburse the health care provider under the
version of the diagnostic or procedure code that was specified in IC 27-1-1.5 on the date that the services were provided.

Legislative History

As added by P.L.161-2001, SEC.3. Amended by P.L.66-2002, SEC.15; P.L.124-2018, SEC.78.