IC 16-51-1-7: "Institutional provider form"

Sec. 7. (a) As used in this chapter, "institutional provider form" means a medical claim form that:

(1) is accepted by the federal Centers for Medicare and Medicaid Services for use by institutional providers; and

(2) does not include a claim field for disclosure of the site at which the health care services to which the form relates were provided.

(b) The term includes the following:

(1) The HIPAA X12 837I institutional form or its successor form.

(2) The CMS-1450 form or its successor form.

(3) The UB-04 form or its successor form.