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Indiana Code Title 27. Insurance § 27-8-22.1-5

Current as of January 02, 2024 | Updated by Findlaw Staff

Sec. 5. (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.

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Cite this article: FindLaw.com - Indiana Code Title 27. Insurance § 27-8-22.1-5 - last updated January 02, 2024 | https://codes.findlaw.com/in/title-27-insurance/in-code-sect-27-8-22-1-5/

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