La. Admin. Code tit. 40 § I-4317

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

Section I-4317 - Billing Instructions

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

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La. Admin. Code tit. 40, § I-4317

Promulgated by the Department of Labor, Office of Workers' Compensation, LR 19:54 (January 1993), repromulgated LR 19:212 (February 1993), amended LR 20:1299 (November 1994).

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