Proprietary Laboratory Analyses Changes (IB 24-16)

Date: 05/23/24

Louisiana Healthcare Connections is sharing with providers an update to Proprietary Laboratory Analyses Changes (IB 24-16).

Effective May 1, 2024, Louisiana Medicaid coverage of the Current Procedural Terminology (CPT) Proprietary Laboratory Analyses codes 0202U, 0223U, 0224U, 0225U, 0226U, 0240U and 0241U will be limited solely to services performed in a (UB-04) facility,  observation and/or inpatient setting. These procedure codes are no longer covered in an outpatient setting as such they have been removed from the Laboratory and Radiology Fee Schedule.

Louisiana Healthcare Connections is updating our systems and will automatically recycle claims within 30 days of this notice. Claims previously submitted will be systematically adjusted to ensure proper payment. No action is required by the provider.

Questions regarding this message and fee-for-service claims are to be directed to Gainwell Technologies at (800) 473-2783 or (225) 924-5040.

Providers with questions for Louisiana Healthcare Connections may contact their Provider Representative at 1-866-595-8133.