Louisiana Administrative Code
Title 40 - LABOR AND EMPLOYMENT
Part I - Workers' Compensation Administration
Subpart 1 - General Administration
Chapter 3 - Electronic Billing
Section I-307 - Billing Code Sets
Universal Citation: LA Admin Code I-307
Current through Register Vol. 50, No. 9, September 20, 2024
A. Billing codes and modifier systems identified below are valid codes for these workers' compensation transactions, in addition to any code sets defined by the standards adopted in Section 305
1. "CDT-4 Codes"-codes and nomenclature
prescribed by the American Dental Association.
2. "CPT-4 Codes"-the procedural terminology
and codes contained in the "Current Procedural Terminology, Fourth Edition," as
published by the American Medical Association and as adopted in the appropriate
fee schedule contained in Title 40 of the Louisiana Administrative
Code.
3. "Diagnosis Related Group
(DRG)"-the inpatient classification scheme used by CMS for hospital inpatient
reimbursement. The DRG system classifies patients based on principal diagnosis,
surgical procedure, age, presence of co-morbidities and complications, and
other pertinent data.
4.
"HCPCS"-CMS' Healthcare Common Procedure Coding System, a coding system which
describes products, supplies, procedures, and health professional services and
which includes the American Medical Association's (AMA's) Physician "Current
Procedural Terminology, Fourth Edition," (CPT-4) codes, alphanumeric codes, and
related modifiers.
5. "ICD-9-CM
Codes"-diagnosis and procedure codes in the International Classification of
Diseases, Ninth Revision, Clinical Modification published by the United States
Department of Health and Human Services.
6. "ICD-10-CM/PCS Codes"-diagnosis and
procedure codes in the International Classification of Diseases, Tenth Edition,
Clinical Modification/Procedure Coding System maintained and published by the
United States Department of Health and Human Services.
7. "NDC"-National Drug Codes of the Food and
Drug Administration.
8. "Physical
Therapy"/"Occupational Therapy Codes: Codes specified in Title 40 of the LAC
covering physical therapy and occupational therapy services.
9. "Revenue Codes"-the four digit coding
system developed and maintained by the National Uniform Billing Committee for
billing inpatient and outpatient hospital services, home health services, and
hospice services.
10. "National
Uniform Billing Committee codes"-code structure and instructions established
for use by the National Uniform Billing Committee (NUBC), such as occurrence
codes, condition codes, or prospective payment indicator codes. These are known
as UB 04 Codes.
AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1203.2.
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