LAC 40:I.4315
LAC 40:I.4315. Noncovered Services
Cite as La. Admin. Code tit. 40, pt. I, § 4315
A. In general, only those equipment items listed in the section of this manual entitled "Maximum Allowances" will be reimbursed. The use of otherwise unlisted HCPCS codes may be covered when medical necessity is documented.