Indiana § 27-8-22.1-5 Use of diagnostic or procedure codes

Indiana Statutes

§ 27-8-22.1-5 — Use of diagnostic or procedure codes

Indiana § 27-8-22.1-5

Title 27INSURANCE

Art. 8LIFE, ACCIDENT, AND HEALTH

Ch. 22.1Claims

This text of Indiana § 27-8-22.1-5 (Use of diagnostic or procedure codes) is published on Counsel Stack Legal Research, covering Indiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Ind. Code § 27-8-22.1-5 (2026).

Text

(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)an insurer 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 insurer pays claims for services provided under an accident and sickness insurance policy or a worker's compensation policy; and

(2)a provider shall begin using the version specified in IC 27-1-1.5 of the:

(A)Current

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(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) an insurer 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 insurer pays claims for services provided
under an accident and sickness insurance policy or a worker's
compensation policy; and
(2) a 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 provider submits claims for payment for
services provided under an accident and sickness insurance policy
or a worker's compensation policy.
(b) If a provider provides services that are covered under an
accident and sickness insurance policy or a worker's compensation
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 insurer begins using the version specified in IC 27-1-1.5 of the diagnostic or procedure code;
the insurer shall reimburse the 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.