Ala. Admin. Code r. 560-X-34-.04

Current through Register Vol. 43, No. 1, October 31, 2024

Section 560-X-34-.04 - Claims Filing Instructions

For time limits on claims submission, refer to the Radiology Services Billing Manual.

(1) Claims for radiology services must contain a valid diagnosis code.

(2) Claims submitted must contain the provider number of the radiology facility that actually performed the service.

(3) Claims must not be submitted using any other provider's number, such as the provider number of the referring physician or hospital.

(4) Claims containing fragmentation of radiology services may be recouped through postpayment review.

Author: Alabama Medicaid Agency

Ala. Admin. Code r. 560-X-34-.04

New Rule: Filed September 8, 1998; effective October 13, 1998.

Statutory Authority: State Plan; Title XIX, Social Security Act; 42 C.F.R. Section 440.30, 493.2.