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Library: Policy

317:30-5-101. Coverage for adults

Revised 5-11-00

     Payment is made to certified laboratories for medically necessary services to adults as set forth in this Section.

  • (1) Inpatient services.
    • (A) Claims for inpatient anatomical pathology must be billed by the individual pathologist performing the examination.
    • (B) Inpatient consultations by Pathologists are compensable.  Claim form must include referring physician, diagnosis, and test(s) for which the consultation was requested.
  • (2) Outpatient services.  Payment is made for medically necessary outpatient services:
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