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MedicaidCoverageMedium impact

Inhaled Nitric Oxide - MEDICAID - LOUISIANA (Revised)

Humana·LA · Pediatrics, Cardiology, Pulmonology +1 more·Pharmacy
Effective date
May 18, 2026
We identified it
Jun 24, 2026
Days to comply

Summary

New Medicaid policy in Louisiana establishes specific coverage criteria for inhaled nitric oxide (iNO) therapy, limiting coverage to three specific indications: postoperative pulmonary hypertension management in pediatric patients, vasoreactivity testing in adults with PAH, and hypoxic respiratory failure with PPHN in term/near-term infants. All other uses are considered not medically necessary.

Action Required

Action needed
Before May 18, 2026: Review all inhaled nitric oxide therapy requests to ensure they meet the three specific coverage criteria outlined in the policy. Update prior authorization processes to verify patients meet strict eligibility requirements including gestational age ≥34 weeks for neonates, absence of congenital diaphragmatic hernia, and maximum 14-day treatment duration. Train clinical staff on new medical necessity requirements to prevent claim denials.

Affected Billing Codes

93463