Louisiana Administrative Code
Title 40 - LABOR AND EMPLOYMENT
Part I - Workers' Compensation Administration
Subpart 2 - Medical Guidelines
Chapter 25 - Hospital Reimbursement Schedule, Billing Instruction and Maintenance Procedures
Section I-2533 - Outpatient Revenue Codes Not Billable on the UB-92

Universal Citation: LA Admin Code I-2533

Current through Register Vol. 50, No. 9, September 20, 2024

A. The following revenue codes must be billed on the HCFA 1500 Form.

Revenue Code(s)

Description

274

Medical/Surgical Supplies Prosthetics

277

Medical/Surgical Supplies Take Home Oxygen

290

Durable Medical Equipment (DME) General Classification

291

DME-Rental

292

DME-Purchase

299

DME-Other Equipment

500-539

Outpatient Services, Clinic, Free-Standing Clinic and Osteopathic Services

570-599

Home Health Services

540-549

Ambulance Services

550-559

Skilled Nursing

820-859

Dialysis Service

860-879

Not Assigned

880-889

Miscellaneous Dialysis Services

900-909

Psychiatric/Psychological Treatments

910-919

Psychiatric/Psychological Services

940-949

Therapeutic Services

960-989

Professional Fees

AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1034.2.

Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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