Louisiana Administrative Code
Title 37 - INSURANCE Part
Part XIII - Regulations
Chapter 23 - Regulation 48-Standardized Claims Forms
Section XIII-2311 - Requirements for Use of J512 Form
Current through Register Vol. 50, No. 9, September 20, 2024
A. A dentist shall use the J512 Form and instructions provided by the American Dental Association CDT-1 for use of the J512 Form by billing patients or their representatives directly and filing claims with issuers for professional services.
B. An issuer may not require a dentist to use any other code other than the CDT-1 codes for the initial filing of claims for dental care services.
C. Use of J512 Form shall be effective July 1, 1994 for all issuers excluding reimbursement to dentists reimbursed by Louisiana Medicaid which shall have an effective date of January 1, 1995.
AUTHORITY NOTE: Promulgated in accordance with R.S.22:10, 22:213(A)(14), and 22:3016(C) of the Insurance Code.