1. A. Itemization. Please itemize outpatient charges with the applicable revenue codes. The use of all inclusive ancillary revenue codes is not acceptable.

2. B. Reports. Supporting documentation of services rendered may be attached to billings for outpatient services. Such reports are:

   1. 1. emergency room reports;
   2. 2. operative reports, if surgery was performed; and
   3. 3. discharge summary, if surgery was performed.

Authority Note

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

Historical Note

HISTORICAL NOTE: 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).