Louisiana Administrative Code
Title 40 - LABOR AND EMPLOYMENT
Part I - Workers' Compensation Administration
Subpart 2 - Medical Guidelines
Chapter 43 - Prosthetic and Orthopedic Equipment
Section I-4317 - Billing Instructions
Universal Citation: LA Admin Code I-4317
Current through Register Vol. 50, No. 9, September 20, 2024
A. In addition to the HCFA 1500 Form, the completed Medical Certification Form (LDOL-WC-3002) must be submitted for all initial claims either rental or purchase.
B. DME 3002 Form
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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