CHAPTER 41. CLAIMS

IC 27-13-41
    Chapter 41. Claims

IC 27-13-41-1
Use of diagnostic or procedure codes
    Sec. 1. Not more than ninety (90) days after the effective date ofa diagnostic or procedure code described in this section:
        (1) a health maintenance organization and a limited servicehealth maintenance organization shall begin using the mostcurrent version of the:
            (A) current procedural terminology (CPT);
            (B) international classification of diseases (ICD);
            (C) American Psychiatric Association's Diagnostic andStatistical 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 maintenance organization andlimited service health maintenance organization pay claims forhealth care services covered under an individual contract or agroup contract; and
        (2) a provider shall begin using the most current version of the:
            (A) current procedural terminology (CPT);
            (B) international classification of diseases (ICD);
            (C) American Psychiatric Association's Diagnostic andStatistical 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 forhealth care services covered under an individual contract or agroup contract.
As added by P.L.161-2001, SEC.5. Amended by P.L.66-2002,SEC.18.

IC 27-13-41-2
Reimbursement
    Sec. 2. If a provider provides health care services that are coveredunder an individual contract or a group contract:
        (1) after the effective date of the most current version of adiagnostic or procedure code described in section 1 of thischapter; and
        (2) before the health maintenance organization or limitedservice health maintenance organization begins using the mostcurrent version of the diagnostic or procedure code;
the health maintenance organization or limited service healthmaintenance organization shall reimburse the provider under theversion of the diagnostic or procedure code that was in effect on the

date that the health care services were provided.
As added by P.L.161-2001, SEC.5.