Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XV - Services for Special Populations › Subpart 5 - Early and Periodic Screenings, Diagnosis, and Treatments › Chapter 73 - Personal Care Services › Section XV-7323 - Nonreimbursable Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
				  following services are not appropriate for personal care and are not
				  reimbursable as EPSDT personal care services:
1. insertion and sterile irrigation of
				  catheters (although changing of a catheter bag is allowable);
2. irrigation of any body cavities which
				  require sterile procedures;
3.
				  application of dressing, involving prescription medication and aseptic
				  techniques, including care of mild, moderate or severe skin problems;
4. administration of injections of fluid into
				  veins, muscles or skin;
5.
				  administration of medicine (an EPSDT PCS direct service worker may only
				  remind/prompt about self-administered medication to an EPSDT eligible
				  beneficiary who is over the age of 18);
6. cleaning of the home in an area not
				  occupied by the beneficiary;
a.
				  Repealed.
7. laundry,
				  other than that incidental to the care of the beneficiary;
a. Repealed.
EXAMPLE: Laundering of clothing and bedding for the entire
					 household, as opposed to simple laundering of the beneficiary's clothing or
					 bedding.
8.
				  shopping for groceries or household items other than items required
				  specifically for the health and maintenance of the beneficiary, and not for
				  items used by the rest of the household;
9. skilled nursing services, as defined in
				  the state Nurse Practices Act, including medical observation, recording of
				  vital signs, teaching of diet and/or administration of medications/injections,
				  or other delegated nursing tasks;
10. teaching a family member or friend how to
				  care for a beneficiary who requires frequent changes of clothing or linens due
				  to total or partial incontinence for which no bowel or bladder training program
				  for the patient is possible;
11.
				  specialized nursing procedures such as:
a.
				  insertion of nasogastric feeding tube;
b. in-dwelling catheter;
c. tracheostomy care;
d. colostomy care;
e. ileostomy care;
f. venipuncture; and/or
g. injections;
12. rehabilitative services such as those
				  administered by a physical therapist;
13. teaching a family member or friend
				  techniques for providing specific care;
14. palliative skin care with medicated
				  creams and ointments and/or required routine changes of surgical dressings
				  and/or dressing changes due to chronic conditions;
15. teaching of signs and symptoms of disease
				  process, diet and medications of any new or exacerbated disease
				  process;
16. specialized aide
				  procedures such as:
a. rehabilitation of the
				  beneficiary (exercise or performance of simple procedures as an extension of
				  physical therapy services);
b.
				  measuring/recording the beneficiary's vital signs (temperature, pulse,
				  respirations and/or blood pressure, etc.) or intake/output of fluids;
c. specimen collection;
d. special procedures such as:
i. nonsterile dressings;
ii. special skin care
				  (nonmedicated);
iii. decubitus
				  ulcers;;
iv. cast care;
v. assisting with ostomy care;
vi. assisting with catheter care;
vii. testing urine for sugar and
				  acetone;
viii. breathing
				  exercises;
ix. weight measurement;
				  and
x. enemas;
17. home IV therapy;
18. custodial care or provision of only
				  instrumental activities of daily living tasks or provision of only one activity
				  of daily living task;
19.
				  occupational therapy;
20. speech
				  pathology services;
21. audiology
				  services;
22. respiratory
				  therapy;
23. personal comfort
				  items;
24. durable medical
				  equipment;
25. oxygen;
26. orthotic appliances or prosthetic
				  devices;
27. drugs provided through
				  the Louisiana Medicaid pharmacy program;
28. laboratory services; and
29. social worker visits.