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.