Louisiana Administrative Code
Title 40 - LABOR AND EMPLOYMENT
Part I - Workers' Compensation Administration
Subpart 2 - Medical Guidelines
Chapter 45 - Respiratory Services Reimbursement Schedule, Billing Instructions, and Maintenance Procedures
Section I-4511 - Noncovered Services
Universal Citation: LA Admin Code I-4511
Current through Register Vol. 50, No. 9, September 20, 2024
A. Only those services specifically listed in the section of this manual entitled "Maximum Reimbursement Allowances" are covered. Charges billed under the code for unlisted services or equipment will be reviewed prior to any pricing. Charges for items under this code that were not pre-authorized will be disallowed. Noncovered professional services include but are not limited to:
1. any service considered investigational or
experimental, such as membrane diffusion capacity;
2. services not ordered by a physician or
administered under the direction of a physician or by qualified medical staff;
and
3. services not consistent with
the patient's diagnosis, treatment or respiratory problems.
B. No charge will be allowed for deliveries of equipment unless the point of delivery is more than 50 miles from the provider's place of business.
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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