Rules & Regulations of the State of Tennessee
Title 0780 - Commerce and Insurance
Subtitle 0780-01 - Insurance Division
Chapter 0780-01-73 - Uniform Claims Process for TennCare Participating Managed Care Organizations
Section 0780-01-73-.04 - UNIFORM FORMS REQUIRED

(a) For the purposes of submitting the HCFA-1500/CMS-1500 form, providers should complete the form in accordance with the instructions appended hereto as Appendix A to these rules.

(b) For the purposes of submitting the HCFA-1450/CMS-1450 (UB-92) form, providers should complete the form in accordance with the Medicare instructions.

(c) For the purposes of submitting the "American Dental Association, 1999 Version 2000" uniform dental claim form approved by the American Dental Association for use by dentists, as amended or updated by the American Dental Association, providers should complete the form in accordance with ADA instructions.

(d) For the purposes of submitting the NCPDP prescription drug claim form or its electronic counterpart, providers should complete the form in accordance with NCPDP instructions.

(e) CPT Code Usage. For the purposes of these rules, providers are authorized to use the expiring or updated CPT codes on claims submitted during the period January 1 through March 31 of each year. From April 1 through December 31 of each year, however, providers must use the updated/current CPT codes.

(f) CDT Code Usage. For the purposes of these rules, dentist providers shall utilize the most current CDT codes as required by the federal Health Insurance Portability and Accountability Act of 1996, Pub.L. 104-191, Aug. 21, 1996, 110 Stat. 1936 (HIPAA) rules and regulations for commercial dental benefit programs.

(g) ICD-9 Code Usage. For the purposes of these rules, providers are authorized to use the expiring or updated ICD-9 codes on claims submitted during the period October 1 through subsequent March 31 of each year. From April 1 through December 31 of each year however, providers must use the updated/current ICD-9 codes.

(h) HCPCS Code Usage. For the purposes of these rules, providers are authorized to use the expiring or updated HCPCS codes on claims submitted during the period January 1 through March 31 of each year. From April 1 though December 31 of each year, however, providers must use the updated/current HCPCS codes.