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37.85.413    LIMITATIONS ON CODING ADVICE

(1) Employees of the department, or of any contractor or agent of the department, may give a provider general information as to what codes are available for billing under Medicaid for a particular service or item being provided. However, the provider retains responsibility for selecting and submitting the proper code to describe the service or item provided. If an employee of the department or of a contractor or agent of the department suggests, recommends, or directs the provider to use a particular code from the choices available or gives other specific coding advice, the provider may not rely on such advice unless the advice is provided in writing before the provider submits a claim for the service or item.

History: 53-6-113, MCA; IMP, 53-6-101, MCA; NEW, 2005 MAR p. 459, Eff. 4/1/05.

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