Coverage of Disposable (Elastomeric) Infusion Pumps (IB24-34)

Date: 10/02/24

Louisiana Healthcare Connections is sharing with providers a new coverage for Disposable (Elastomeric) Infusion Pumps (IB24-34) effective September 1, 2024. This coverage will also include supplies as a benefit for short-term use (less than 30 days) for antibiotic infusion therapy.

Prior authorization is required and the request for approval must include the following:

• Information on the underlying diagnosis or condition.
• A physician’s order and documentation supporting medical necessity.
• The name of the antibiotic, dosage, the duration of therapy, and the frequency of administration

The policy for elastomeric infusion pumps is in the Durable Medical Equipment Program Manual, Section 18.2.28, and the Healthcare Common Procedure Coding System (HCPCS) code is on the Durable Medical Equipment fee schedule, both located on lamedicaid.com.

Questions regarding fee-for-service claims should be directed to Gainwell Technologies Provider Relations at (800) 473‐2783 or (225) 924‐5040.

Providers can call Louisiana Healthcare Connections with questions regarding managed care claims at 1-866-595-8133.

For questions related to this informational bulletin, please contact Irma Gauthier at Irma.Gauthier2@la.gov or via phone at (225) 342-5691.