Indiana Code § 16-51-1-5

"Individual provider form"
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Sec. 5. (a) As used in this chapter, "individual provider form" means a medical claim form that: (1) is accepted by the federal Centers for Medicare and Medicaid Services for use by individual providers or groups of providers; and (2) includes a claim field for disclosure of the site at which the health care services to which the form relates were provided.       (b) The term includes the following: (1) The CMS-1500 form or its successor form. (2) The HCFA-1500 form or its successor form. (3) The HIPAA X12 837P electronic claims transaction for professional services, or its successor transaction.

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