OHCA Policies and Rules

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317:30-5-101.Coverage for adults
[Revised 7-01-99]
Payment is made to certified laboratories for medically necessary services to adults as set forth in this Section.
(1) Inpatient services.
(A) Claims for inpatient anatomical pathology must be billed by the individual pathologist performing the examination.
(B) Inpatient consultations by Pathologists are compensable. Claim form must include referring physician, diagnosis, and test(s) for which the consultation was requested.
(2) Outpatient services. Payment is made for medically necessary outpatient services:

Disclaimer. The OHCA rules found on this Web site are unofficial. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.