{"data":{"id":"us-in/ic-27-8-22.1-5","jurisdiction":"us-in","citation":"IC 27-8-22.1-5","heading":"Use of diagnostic or procedure codes","body":"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:\n(1) an insurer shall begin using the version specified in IC 27-1-1.5 of the:\n(A) Current Procedural Terminology (CPT);\n(B) International Classification of Diseases (ICD);\n(C) American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM);\n(D) Current Dental Terminology (CDT);\n(E) Healthcare Common Procedure Coding System (HCPCS); and\n(F) third party administrator (TPA);\ncodes under which the insurer pays claims for services provided under an accident and sickness insurance policy or a worker's compensation policy; and\n(2) a provider shall begin using the version specified in IC 27-1-1.5 of the:\n(A) Current Procedural Terminology (CPT);\n(B) International Classification of Diseases (ICD);\n(C) American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM);\n(D) Current Dental Terminology (CDT);\n(E) Healthcare Common Procedure Coding System (HCPCS); and\n(F) third party administrator (TPA);\ncodes under which the provider submits claims for payment for services provided under an accident and sickness insurance policy or a worker's compensation policy.\n(b) If a provider provides services that are covered under an accident and sickness insurance policy or a worker's compensation policy:\n(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\n(2) before the insurer begins using the version specified in IC 27-1-1.5 of the diagnostic or procedure code;\nthe 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.","path":["TITLE 27. INSURANCE","ARTICLE 8. LIFE, ACCIDENT, AND HEALTH","Chapter 22.1. Claims"],"source_url":"https://iga.in.gov/ic/2026/Title_27.html#27-8-22.1-5","current_through":"2026","vintage":"2026","retrieved_at":"2026-09-25T05:39:04Z","sha256":"70a787478445173908b65b7120ab887ddddf286f423cab54f01c3855f3ed3925","source_id":"us-in","stale":false,"prev":"us-in/ic-27-8-22.1-4","next":"us-in/ic-27-8-23-1"},"notice":"GroundRules: Original legal text. Not legal advice."}