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Important Prior Authorization Updates Effective October 15, 2025

Date: 09/12/25

As part of our ongoing commitment to improving the prior authorization (PA) process for both providers and members, Louisiana Healthcare Connections is implementing updates to our PA requirements. These changes are designed to streamline submission and approval processes and facilitate timely access to high-quality care.

We understand that changes to PA requirements can impact your workflows, and we want to ensure you have the information and support you need.  Changes include:

  • Adding and removing select PA requirements based on criticality of review and clinical need.
  • Creating a more uniform set of prior authorization requirements across lines of businesses, making the process more consistent for providers.

Our goal with these changes is to simplify processes, reduce confusion for providers, and support future efforts to expand real-time responses to requests.

If you have questions about specific prior authorization codes or how these updates affect your practice, please reach out to your local Provider Engagement representative or contact Louisiana Healthcare Connections’ provider services team at 1-866-595-8133.

We appreciate your continued partnership in providing care to your patients and our members.                                                         

PA Now Required:         

  • Behavioral Health, Substance Abuse Treatment: H0004
  • Cardiovascular, Heart Surgery: 92928, 93656
  • DME Services, Incontinence Supplies: T4521, T4522, T4523, T4524
  • DME Services, Neurostimulators: C1767
  • Home Services, Home Management: S5165
  • Hospice, Hospice Services: Q5001, Q5002, Q5003, T2042
  • Laboratory, Urinalysis: G0480, G0481
  • Other Medical Services, Surgical Supplies: A4554
  • Skin Procedures, Muscle Flap Procedures: 15734
  • Skin Procedures, Digestive System: 49505, 49650
  • Surgery Procedures, Female Genitalia: 58662
  • Surgery Procedures, Integumentary System: 19301, 19357
  • Surgery Procedures, Male Genitalia: 54360
  • Transportation Service, Medical Transportation: A0431, A0436   

No PA Required:

  • Surgery Procedures, Vascular: 36471
  • Home Services, Home Management: S9211, S9214