Billing Beat

LSA 18-375 Radiology Rule

June 5, 2019

Amends 405 IAC 5-27-1 to update definitions and terminology.

Amends 405 IAC 5-27-2 to clarify prior authorization and service limitations for radiologic procedures.

Amends 405 IAC 5-27-3 to update definitions and terminology and revise Medicaid policy for computerized tomography scans. Amends 405 IAC 5-27-6 to update terminology and revise Medicaid policy for sonography procedures.

Adds 405 IAC 5-27-7 to implement reimbursement and prior authorization policy for positron emission tomography scans.

Adds 405 IAC 5-27-8 to implement reimbursement and prior authorization policy for interventional radiology procedures.

Adds 405 IAC 5-27-9 to implement reimbursement policy for magnetic resonance imaging.

Effective 30 days after filing with the Publisher. Statutory authority: IC 12-15-1-10; IC 12-15-21-1; IC 12-15-21-2; IC 12-15-21-3.

Source: https://www.in.gov/fssa/files/LSA_18-375_Radiology_Docket.pdf

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