Section 405 IAC 5-26-4 - Laboratory or x-ray servicesAuthority: IC 12-15-1-10; IC 12-15-21-2; IC 12-15-21-3
Affected: IC 12-13-7-3; IC 12-15
Sec. 4.
(a) Medicaid will reimburse a podiatrist for laboratory or x-ray services only if the services are rendered by or under the personal supervision of the podiatrist. Services ordered by a podiatrist, but performed by a laboratory or x-ray facility, shall be billed directly to Medicaid by the laboratory or x-ray facility. The podiatrist may be reimbursed for handling or conveyance of a specimen sent to an outside laboratory in accordance with 405 IAC 5-18.(b) Medicaid reimbursement is not available for comparative foot x-rays, unless prior authorized.(c) Medicaid reimbursement is available for the following lab and x-ray services billed by a podiatrist: (1) Cultures for foot infections and mycotic (fungal) nails for diagnostic purposes.(2) Sensitivity studies for treatment of infection processes.(3) Medically necessary presurgical testing.Office ofthe Secretary of Family and Social Services; 405 IAC 5-26-4; filed Jul 25, 1997, 4:00p. m.: 20 IR 3349; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; readopted filed Sep 19, 2007, 12:16 p.m.: 20071010-IR-405070311RFA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFAReadopted filed 11/13/2019, 11:54 a.m.: 20191211-IR-405190487RFAReadopted filed 5/30/2023, 11:54 a.m.: 20230628-IR-405230292RFA