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
Statutory Authority: State Plan; Title XIX, Social Security Act; 42 C.F.R. Section 440.30, 493.2.
History: New Rule: Filed September 8, 1998; effective October 13, 1998.