Ind. Code ch. 27-8-22.1

Ind. Code § 27-8-22.1-1 "Accident and sickness insurance policy" defined

Sec. 1. As used in this chapter, "accident and sickness insurance policy" means an insurance policy that provides at least one (1) of the types of insurance described in IC 27-1-5-1, Classes 1(b), 2(a), 2(b), 2(e), 2(f), and 2(h). As added by P.L.161-2001, SEC.4.

Ind. Code § 27-8-22.1-2 "Insurer" defined

Sec. 2. As used in this chapter, "insurer" means: (1) an insurer that issues: (A) an accident and sickness insurance policy; or (B) a worker's compensation policy; or (2) an employer who has received a certificate from the worker's compensation board to carry the employer's worker's compensation risk without insurance under IC 22-3-2-5. As added by P.L.161-2001, SEC.4.

Ind. Code § 27-8-22.1-3 "Provider" defined

Sec. 3. As used in this chapter, "provider" has the meaning set forth in IC 27-8-11-1. As added by P.L.161-2001, SEC.4.

Ind. Code § 27-8-22.1-4 "Worker's compensation policy" defined

Sec. 4. As used in this chapter, "worker's compensation policy" means a policy of insurance issued to an employer under IC 22-3-2-5. As added by P.L.161-2001, SEC.4.

Ind. Code § 27-8-22.1-5 Use of diagnostic or procedure codes

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. As added by P.L.161-2001, SEC.4. Amended by P.L.66-2002, SEC.16; P.L.124-2018, SEC.84.