Regulation .05 Limitations.
Regulation .05 Limitations.LinkCopy Citation
The Program does not cover the following:
A.
Services for which the IDTF provider cannot supply a properly completed order identifying the authorized ordering practitioner by National Provider Identifier (NPI);
B.
IDTF services ordered by an:
(1)
Individual who is not enrolled as a provider in the Program with an active status on the date of service; and
(2)
Entity, facility, or another provider that is not an individual.
C.
Services not adequately documented in the recipient’s medical record;
D.
Services not medically necessary;
E.
Procedures that are the provider as investigational or experimental in nature;
F.
Services which are specifically included as an integral part of another service;
G.
Consultations;
H.
Office Visits;
I.
Injections;
J.
Surgeries; and
K.
Therapeutic services.