Section 27-8-22.1-5 - Use of diagnostic or procedure codes(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.
Amended by P.L. 124-2018,SEC. 84, eff. 7/1/2018.As added by P.L. 161-2001, SEC.4. Amended by P.L. 66-2002, SEC.16.