<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 10.09.87.05" title_num="10" subtitle_num="09" chapter_num="87" heading="Limitations.">
  <text>The Program does not cover the following:</text>
  <paragraph num="A.">
    <text>Services for which the IDTF provider cannot supply a properly completed order identifying the authorized ordering practitioner by National Provider Identifier (NPI);</text>
  </paragraph>
  <paragraph num="B.">
    <text>IDTF services ordered by an:</text>
    <paragraph num="(1)">
      <text>Individual who is not enrolled as a provider in the Program with an active status on the date of service; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Entity, facility, or another provider that is not an individual.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Services not adequately documented in the recipient’s medical record;</text>
  </paragraph>
  <paragraph num="D.">
    <text>Services not medically necessary;</text>
  </paragraph>
  <paragraph num="E.">
    <text>Procedures that are the provider as investigational or experimental in nature;</text>
  </paragraph>
  <paragraph num="F.">
    <text>Services which are specifically included as an integral part of another service;</text>
  </paragraph>
  <paragraph num="G.">
    <text>Consultations;</text>
  </paragraph>
  <paragraph num="H.">
    <text>Office Visits;</text>
  </paragraph>
  <paragraph num="I.">
    <text>Injections;</text>
  </paragraph>
  <paragraph num="J.">
    <text>Surgeries; and</text>
  </paragraph>
  <paragraph num="K.">
    <text>Therapeutic services.</text>
  </paragraph>
</regulation>