A claim for services provided under this chapter must be submitted at the hospital's usual and customary charge to the general public and must comply with the informational requirements established in the Official UB-04 Data Specifications Manual 2023.
Claims for outpatient laboratory services must contain the applicable procedure codes from the Current Procedural Terminology adopted in § 67:16:01:25.
S.D. Admin. R. 67:16:03:14
General Authority: SDCL 28-6-1(4).
Law Implemented: SDCL 28-6-1.
Official UB-04 Data Specifications Manual 2023, https://www.nubc.org/ub-04-products; $165.00. Claims, ch 67:16:35.