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(2) claims submitted for miscellaneous HCPCS codes under this section for which a product-specific rate has not been established and published on the Alaska Medicaid DMEPOS Fee Schedules, Tables I-5 through I-9, adopted by reference in 7 AAC 160.900, or Alaska Medicaid DMEPOS Interim Fee Schedule must be submitted with an unaltered final purchase invoice, free of alteration described in (k) of this section; claims submitted without an unaltered final purchase invoice or with anything other than an unaltered final purchase invoice will be denied. (e) Rates established by the department under this section for a covered code for which CMS has not issued a rate may be published on the department’s Alaska Medicaid DMEPOS Interim Fee Schedule. (f) A provider enrolled under 7 AAC 120.300 as a prosthetics and orthotics provider may submit claims for labor and repair parts for damaged prosthetics, orthotics, and related items and services with the following limitations:

(1) the department will not pay more than the corresponding labor rate listed on the Alaska Medicaid DMEPOS Fee Schedule, Tables I-5 through I-9, adopted by reference in 7 AAC 160.900, for which CMS has issued a price for each 15 minutes of labor costs;

(2) the billing for a repair part must reflect a charge that complies with the applicable standards in 7 AAC 145.020 and this section;

(3) labor and repair parts for the item or service must be documented and the documentation must be submitted with each claim; documentation must include

(A) a statement signed by the recipient or the recipient’s authorized representative that describes the cause for and nature of the repair;

(B) a description of the item or service being repaired and its serial number, if available;

(C) the beginning and end dates of warranty coverage, if available;

(D) documentation for labor charges that includes the amount of time spent on the repair, rounded up to the nearest quarter hour, and the hourly rate charged for the repair; and

(E) an itemized list of parts used in the repair and associated costs;

(4) a provider may not submit a claim for labor and repair parts if the item is covered under a manufacturer’s or supplier’s warranty, or if the labor or parts are necessary to repair an item that needs repair because of a manufacturer’s defect;

(5) a provider may not submit a claim for labor and repair parts for a rented item; the provider shall ensure that a rented item functions as intended after the provider repairs or replaces the item. (g) Payment using a miscellaneous HCPCS code as defined in 7 AAC 120.399 for