PROVIDER UPDATE

VOLUME 9, NUMBER 2

APRIL 1992


Recipient Eligibility Card New Hcfa-1500 Forms: Ordering Information
Claims Resolution Procedures Change in Billing Instruction for Codes 7740-52, 77425-52, and 77430-52
Neonatal Critical Care Units for 95920
Funding for 99238 Increase in Fees for 93307 and 93308
Critical Care Policy Changes HCFA-1500 Difficulties
Insertion and Removal of Norplant Funding of Technical Component Codes
The MT-3 Form The MT-4 Form
Nicotine ADH. Patches Error 462 Denials
Drug Limits Suspended MAC Overrides
Immunosuppressant Drugs Using Correct NDCS When Billing
Diabetic Supplies DME and M.D. Prescription Requirements
Wheelchairs Requesting Approval

Increase in Fees for Critical Care Codes 99291 &99292


ALL PROVIDERS

RECIPIENT ELIGIBILITY CARD

Medicaid of Louisiana is now printing a different message on Louisiana recipient Medical Eligibility cards for recipients who are eligible for KIDMED/EPSDT services.  Providers should review the example provided in the Attachments section of this issue of the Provider Update.


NEW HCFA-1500 FORMS:  ORDERING INFORMATION

The revised HCFA-1500 claim form may be ordered from the Superintendent of Documents and negatives for the HCFA-1500 may be obtained from the Government Printing Office (GPO).  Providers should note that copy machine copies of the HCFA-1500 are not acceptable.

The Superintendent of Documents will sell copies of the 1500 as indicated below.

NOTE:  All the forms listed below are sensor coded.

Type of Form                   Quantity Per Package                Stock Number

Single Sheet                               100                                017-060-00468-1

2-Part Snapout                          100                                017-060-00469-0

1-Part Continuous                      2500                              017-060-00470-3

2-Part Continuous                      1400                              017-060-00471-1

NOTE:  On any order of 100 packages or more to be shipped to one address, a 25% discount may be applied.  For orders of 100,000 copies or more, the Superintendent of Documents can furnish the 1500 preprinted with the practitioner's name, address, and ID number, or he can customize the form in certain other ways.  For further information when ordering 100,000 copies, providers should call Mr. Howard Johnson at (202) 521-2404.

Checks, money orders, or mail orders should be mailed to the following address:

U.S. Government Printing Office
Superintendent of Documents
Washington, DC  20402

Providers charging orders to Mastercard, Visa, Choice, or SupDocs Deposit Accounts should call (202) 783-3238 (SupDocs Order Desk) between 8:00 A.M. and 4:30 P.M. Eastern time.

NOTE:  Orders must be placed with the SupDocs stock number.

The GPO will sell negatives and a specifications package which may be used for printing the 1500.  With these negatives, the printer may produce copies of the 1500.  This negative may be reused indefinitely.  The negatives may be altered to overprint a name, address, and ID number.  The negatives may be purchased by check or money order payable to "The Public Printer."  Providers should forward orders for the negatives to the Asst. Supt. Of Dept. Acct. Rep. Div., U.S. Govt. Printing Office, Room C-830, Washington, DC 20401.  Providers should not submit a purchase order, voucher, or similar form for purchase because this office can process payments by check or money order only.

The GPO will ship orders approximately 5 working days after receipt of the order.  If additional information is needed in ordering negatives, providers should contact Robin Wilkins at (202) 512-1257.

Providers who have questions about any of the ordering information provided in this article may call (504) 927-3390.


CLAIMS RESOLUTION PROCEDURES

It has come to our attention that there is a misunderstanding among providers regarding the correct procedure for claims resolution.  If a claim is over one year old, then it must be submitted to Unisys Provider Relations with a request for an override of the timely filing limitations and documentation which reflects that the claim was originally timely filed.  Documentation of timely filing may be a remittance advice or correspondence from either Unisys or the Bureau of Health Services Financing which identifies the claim and reflects that it was filed within one year of the date of service.

If a claim is over two years old, then it must be submitted to the Hospital Program with a request for an override of the timely filing limitation, documentation of timely filing, and documentation of the provider's attempt to resolve the billing problem.  If the provider does not have documentation of timely filing because the patient became eligible for Medicaid retroactively, then the claim must be submitted to the MMIS Section with documentation of retroactive eligibility.  Documentation of retroactive eligibility may be either a copy of the patient's Medicaid eligibility card or correspondence from the local Office of Family Support which identifies the period of retroactive eligibility.

Claims requiring resolution should be sent to one of the following addresses:

One Year Old:

Paramax Systems Corporation
P. O. Box 91024
Baton Rouge, LA  70821
Attention:  Provider Relations

Two Years Old:

B.H.S.F.
P. O. Box 91030
Baton Rouge, LA  70821
Attention:  Sandra Victor, Hospital Program


Retroactive Eligibility

If a claim is over one year old or if a claim is over two years old and the provider has documentation that the date of service falls within a recipient's retroactive period of Medicaid eligibility, the claim should be sent with documentation attached to the following address:

B.H.S.F.
P. O. Box 91030
Baton Rouge, LA  70821
Attention:  Cathy Troy, MMIS/Claims Resolution Unit 

NOTE:  Claims involving retroactive eligibility must be submitted to MMIS within one year of the patient becoming Medicaid eligible.


CHANGE IN BILLING INSTRUCTIONS FOR CODES 77420-52, 77425-52, AND 77430-52

Physicians and billing clerks should read the article entitled "Billing Instructions for CPT-4 Codes 77420, 77425, and 77430," which is printed on page 13 of the October 1991 issue of the Provider Update for we are, with this notification, changing the billing instructions for codes 77420-52, 77425-52, and 77430-52, effective with claims processed after May 1, 1992, to allow these codes to be billed electronically.  These changes in billing instructions should also alleviate the problem providers and our Medical Review Unit are having with the new HCFA-1500 form its lack of a description column.

Effective with claims received after May 1, 1992, providers should begin billing in the following manner for complete courses of therapy consisting of numbers of fractions not evenly divisible by 5:

Providers should place either code 77420-52, 77425-52, or 77430-52 (CPT/HCPCS-Modifier) in Item 24D of the claim form and the number of fragments being billed, either 1, 2, 3, or 4, in Item 24G (Days or Units column).

Then, the computer will pay either one-fifth, two-fifths, three-fifths, or four-fifths of the fee on file for the code billed.

For example, to bill for a complete course of therapy in which 23 fragments were given, code 77420 (assuming the simple level of treatment was given) should be placed in Item 24D, and 4 should be placed in Item 24G.  Then, code 77420-52 and 3 should be placed in Items 24D and 24G, respectively, on the next line of the claim form.

To bill for a complete course in which 7 fragments were given, code 77430 (assuming complex treatment was rendered) should be placed in Item 24D, and 1 should be placed in Item 24G.  On the next claim line, code 77430-52 and 2 should be placed in Items 24D and 24G, respectively.

NOTE:  The numbers 1 through 4 are the only numbers that should be used in the units column if the code being billed is modified.

Also, span dates should continue to be used.

If questions arise concerning these instructions, providers should call Kandis V. McDaniel, Physicians Program Manager, at (504) 342-9490.


INCREASE IN FEES FOR CRITICAL CARE CODES 99291 & 99292

Medicaid of Louisiana is pleased to announce an increase in fees for critical care services (CPT-92 codes 99291 and 99292), effective with date of service January 1, 1992.  The fee for code 99291 was increased to $207.00, and the fee for code 99292 was increased to $128.00.

NOTE:  Adjustments may be requested.


NEONATAL CRITICAL CARE

In billing for neonatal critical care services, the coding section of the American Medical Association has advised that neonatologists may bill code 99291 (Critical care; first hour), even though they may not spend a full 60 minutes with each neonate they see on a given day.  In other words, if a neonatologist spends only ten minutes on a given day with Baby A, he may still bill code 99291 on that day for that child.  However, the 10, 35, or 50 minutes spent must be spent with the child before 99291 may be billed.  Code 99291 may not be billed if all the critical care provider does is spend time in the unit directing the auxiliary personnel.  Only time actually spent with the patient may be counted.

Additionally, the doctor may not bill for an additional thirty minutes of care (code 99292) until he has spent a full 60 minutes with the child.  Therefore, records must be documented.  Again, just being in the unit and directing others does not count.  The time billed must have been spent with the baby.  If the professional bills code 99292 after having spent only 50 minutes with Baby A and 15 minutes directing personnel, he will have billed code 99292 in error.


UNITS FOR 95920

The number of units that may be billed per day for procedure code 95920 (Intraoperative neurophysiology testing, per hour) has been increased from one to four.  Hours of testing over four will pend to the Medical Review Unit for review.  The fee for each hour of testing is $50.00.


FUNDING FOR 99238

CPT-92 procedure code 99238 (Hospital discharge day management) has been funded at $32.00, effective with date of service January 1, 1992.  Now, providers should bill code 99238, rather than code 90260 (Subsequent hospital care, each day; intermediate service), for the last day of inpatient care.


INCREASE IN FEES FOR 93307 AND 93308

The fees for Echocardiography (procedure codes 93307 and 93308) have been increased to $208.00 and $113.00, respectively, effective with date of service November 1, 1991.  Adjustments may be requested.


CRITICAL CARE POLICY CHANGE

Medicaid of Louisiana is pleased to announce that, effective with date of service January 1, 1992, claims for concurrent critical care services (procedure codes 99291and 99292) for recipients to the age of 21 will be honored.

Prior to January 1, 1992, error edit 730 (One inpatient hospital initial/subsequent care visit allowed per day) prevented the payment of second, third, and fourth claims for visit services to Client A.  As a result, the provider whose claims was processed first was the only one to receive payment.

This edit has been lifted for critical care services only for only clients to the age of 21 effective with the date of service stated above.

Providers who may have had claims for critical care services denied since January 1, 1992, may rebill.


HCFA-1500 DIFFICULTIES

Our medical review unit has begun reviewing claims submitted on the new HCFA-1500 claim form and are having difficulty with those claims where the procedure code pends for review and where the medical review resolution procedures require a description.  There is no place on the form for a description; and, therefore, we are having to deny some of the claims and request a report.

However, if providers billing codes 90742, 95150, 95155, and 99070 would attach a report to their claims before submitting them for processing, we would be able to reduce the number of claims being denied.  If claims with these codes are submitted without a report, the claims will be denied with the error codes listed below:

732 Attach detailed description of procedure

925 Send office records for date of service

950 Attach both operative and history report


PHYSICIANS & CERTIFIED NURSE MIDWIVES

INSERTION AND REMOVAL OF NORPLANT

Certified nurse midwives may bill and be reimbursed for the insertion and removal of the Norplant contraceptive implant effective with date of service May 1, 1991.

At the current time, the codes for Norplant insertion and removal are 58302 and 58303.  However, effective with date of service April 1, 1992, these codes will be replaced by codes 11975 (Insertion or reinsertion, implantable contraceptive capsules) and by 11976 (Removal without reinsertion, implantable contraceptive capsules).  Fees will remain the same.

Providers who check their Norplant patients a week after implantation may bill for no higher level of visit than a problem-focused exam with straightforward medical decision making (code 99201, $22.00) if the patient is new or for no higher than a minimum visit (code 99211, $14.00) if the patient is established.


RADIATION TREATMENT DELIVERY CENTERS

FUNDING OF TECHNICAL COMPONENT CODES

The technical component codes for radiation treatment delivery (procedure codes 77401 and 77416) have been placed on the procedure/formulary file effective with date of service January 1, 1992.  These codes replace the "Y" alpha-numeric codes which were placed in non-pay status effective  the same date.  The fees for codes 77401 through 77416 are as follows:

         CODE                            FEE ($)

         77401                             22.00

         77402                             53.00

         77403                             26.00

         77404                             64.00

         77406                             80.00

         77407                             56.00

         77408                             76.00

         77409                             79.00

         77411                             90.00

         77412                             56.00

         77413                             76.00

         77414                             89.00

         77416                             90.00


TRANSPORTATION PROVIDERS

THE MT-3 FORM

Non-emergency medical transportation providers are expected to provide MT-3 forms (Verification of Medical Transportation) to the recipient, who is, in turn, expected to certify that the authorized transportation was received by signing the form. 

Then, the MT-3 form is returned to the driver after a signature is obtained from the medical provider's office, indicating that the recipient received the service.

Providers/drivers are not permitted to obtain recipient or medical signatures until after the services have been provided.  If transportation providers find that driver's have presigned MT-3 forms in inventory, all such forms should be destroyed immediately.

Failure to comply with this policy will result in future recoupments.


THE MT-4 FORM

Effective July 1, 1991, all claims submitted without the current MT-4 (Daily Trip Log) will be subject to recoupment payments.

A sample form and the appropriate instructions are provided in the attachments section of this issue of the Provider Update.  Providers should use the attached form for copying their inventory.


PHARMACISTS AND PRESCRIBERS

NICOTINE ADH.PATCHES

Nicotine adhesive patches are covered only with a handwritten prescription signed by the prescribing practitioner, i.e., an original script only, with no provisions for refills; i.e., the physician will need to rewrite a prescription each time.

Also, physicians must certify, in their own handwriting, either directly on the prescription or on an attachment to the prescription that recipients are enrolled in a physician-supervised behavioral program in order for Medicaid to provide coverage for nicotine adhesive patches.


ERROR 462 DENIALS

We have been notified by drug manufacturers through the submission of drug utilization rebate data that pharmacists are billing and getting reimbursed for NDC numbers which are obsolete/discontinued or which have expired shelf-life dates.

Thus, we ask that providers use the NDC for the drug product from the package from which the drug is being dispensed.  Otherwise, the claim will be denied for the improper NDC with error message 462 (Manufacturer notified us that NDC is obsolete.)


DRUG LIMITS SUSPENDED

Effective for services beginning January 28, 1992, the Federal Upper Limits on the following drugs have been suspended:

Generic Name:
Tetracycline Hydochloride
125mg/5ml syrup 480ml

Gentamicin
Sulfate Opth. Oint.
3mg/gm  

Primidon,
250mg tablet

Trigexyphenidyl HCI
2mg tablet
5mg tablet
 

Adjustments should be submitted. 

Effective December 9, 1991, the limits for the following drug were suspended:

Generic Name:  Verapamil Hydrochloride 40mg tablets.

 


MAC OVERRIDES

Bureau reports and audit findings continue to disclose that providers who tape bill have high percentages of Maximum Allowable Costs (MAC) override claims.  When these providers are audited, findings for these providers do not reveal that the wording "brand necessary" or "brand medically necessary" was on the prescription.

Additional research reveals that this problem is occurring even when single source drugs or multi-source drugs which do not have a MAC are billed.

In addition, we have identified some tape billing systems which have software packages that do not contain appropriate fields to reflect authorized MAC overrides.  For example, one software package has a field which indicates whether generic substitution is allowed.  The default can be programmed to indicate yes or no.  If yes is entered, then generic substitution is allowed, and no MAC override occurs.  If no is entered, then generic substitution is not allowed, and a MAC override occurs.

Another software package may indicate whether the pharmacist may "Dispense as written."  This field is used to reflect that a drug was dispensed as the physician prescribed, and it allows a MAC override whether or not a valid MAC override was authorized when yes was entered for that field.

Thus, providers should verify that their internal procedures for indicating MAC overrides are accurate and are not resulting in claim denials.  We have made a revision to the pharmacy program claims processing system to assist pharmacists in identifying if they are providers with this problem.  This addition is edit 463 which occurs when providers bill for a drug with a MAC override indicator and the drug is not a MAC drug.  The error message on the drug claim rejection notice produced when this error occurs will be "Drug does not need MAC override."

In order to correct drug claim rejection notices, providers must remove the MAC override indicator and resubmit the notice to Paramax for processing.  If the provider is a tape biller, we recommend that the claim be rebilled without the MAC override.

In the near future, we will also be providing an additional field on the remittance advice to reflect those claims which have been processed and had a MAC override on the claim.  This will be noted on the line item for a claim with a "C."  If a "C" is not printed on the remittance advice line item for the claim, then the claim was processed without a MAC override.

Providers should note that state and federal regulations require that the MAC limits for drugs do not apply if, "a physician certifies, in his own handwriting, in his medical judgement, that a specific brand is medically necessary for a particular recipient."  The wording of the certification should testify to the medical necessity of the brand name drug by stating either "brand medically necessary" or "brand necessary."  The phrases "do not substitute," "no generics please," or "dispense as written" are not acceptable for overriding MAC limitations.


IMMUNOSUPPRESSANT DRUGS

There are some providers who continue to have difficulty getting claims for immunosuppressant drugs processed.  Therefore, we are taking this opportunity to describe the coverage of these drugs.

Effective January 1, 1987, Medicare Part B began paying for FDA-approved immunosuppressant drugs.  This benefit is subject to the Part B deductible and coinsurance provisions, and it is limited to a one-year period after the date of the Medicare-covered transplant.

The drugs presently covered under the immunosuppressive drug program are listed as follows:

J7500           Imuran (Azathioprine), oral tablets, 50mg

J7501           Imuran parenteral, vial 100mg/ml

J7502           Sandimmune (Cyclosporin) oral solution, 100mg/ml

J7503           Sandimmune parenteral, 250mg

J7504           Lympocyte Immune Globulin Orthoclone, per ml

J7505           Orthoclone, per ml

W9075         Prednisone oral tablets, 5mg

W9076         Prednisone oral tablets, 10mg

W9077         Sandimmune (Cyclosporin), 25mg capsules

W9078         Sandimmune, 100mg capsules

Claims should first be sent to Transamerica Occidental Life.  Their address is as follows:

Transamerica Occidental Insurance
Medicare Immuno Drug Claims
P.O. Box 50065
Upland, CA 90785-5065
 

After Transamerica Occidental Life has processed the claim, then the claim, as well as the Explanation of Benefits, should be forwarded to Paramax for payment of coinsurance and deductible amounts, where applicable.

HCFA-1500 claim form instructions are included in the Pharmacy Provider Manual on pages 4-3a and 4-3b.

If the transplant date is more than one year old, then the pharmacy claims, as well as the documentation of the transplant date from either the physician or hospital, should be forwarded to the Paramax Provider Relations Unit (TPL) for processing and override of the Medicare eligible edit.

For non-transplant payments with Medicare Part B, the following policy applies:

         "When a prescription is filled for these drugs and the individual is not an organ transplant patient and Is covered by Medicare Part B, providers should attach a copy of a physician statement verifying the diagnosis of each claim submittal."

If the recipient does not have Medicare Part B coverage, providers should bill as they normally would.


USING CORRECT NDCS WHEN BILLING

In accordance with the drug rebate agreements, manufacturers have challenged the drug utilization billed to Medicaid of Louisiana.  Their reasons for disputing our utilization data include the opinion that NDCs are obsolete, discontinued, or that the shelf lives of particular NDCs have expired.  Manufacturers have also disputed the Louisiana Medicaid drug utilization data because they believe that it exceeds their threshold level for this state.

Thus, we will be researching this information and comparing it to our Medicaid utilization data to verify the manufacturer's reasons for disputing Louisiana data.  Based on this review, we will be confirming pharmacists' utilization and purchases for specific NDCs.

Audits and reviews have also identified that pharmacists are billing NDCs specifically for generic products which have not been purchased by their pharmacy.  Audit findings include computerized pharmacies which maintain pull-down menus for NDC billing purposes but do not include the NDC for the generic product which has been purchased and dispensed by the provider.

However, these billing practices are not in accordance with federal and state regulations, requiring that the pharmacist bill the NDC from the actual package from which the pharmacist is dispensing.

We recommend that providers review software programs that are used to identify and correct this problem because failure to comply with program requirements could result in administrative sanctions, including possible termination from the program.

Finally, it is imperative that accurate records be maintained by Medicaid participating pharmacies and that NDC codes submitted for payment be taken from the package from which the drug is dispensed.


PHARMACISTS, PRESCRIBERS AND DME PROVIDERS

DIABETIC SUPPLIES

Prior to April 1, 1992, diabetic supplies required prior approval through the review of medical necessity.

Effective for prescription services beginning April 1, 1992, diabetic supplies for Medicaid EPSDT individuals under the age of 21 with insulin-dependent diabetes mellitus will be transferred from the prior approval program into the pharmacy program.  Aid category 15 (Foster Care Children), however, are not covered.  Aid category 15 is indicated on the Medicaid eligibility card with a 1 and a 5 in the third and fourth digit, respectively, of the eligibility number.

The covered supplies include disposable insulin syringes, blood glucose monitoring strips, urine ketone monitoring strips, and lancets, and they require a prescription.  For disposable syringes, the prescription must contain the prescribing physician's written statement that the recipient is insulin-dependent.

Disposable insulin syringes, blood glucose monitoring strips, and lancets are to be dispensed in the amount of 100 or a month's supply, whichever is greater.

Providers are to bill their usual and customary charges for these supplies.  The maximum payment for these supplies will be the prevailing wholesale cost plus 50%.

Providers should note, however, that blood glucose monitors must still be prior approved through the DME program.  The Prior Authorization Unit will approve a home blood glucose monitor if the following conditions are met:

1.           The recipient is a Type I insulin-dependent diabetic and under the age of 21;

2.           The physician has stated that the recipient or a responsible family member or care taker can be trained to use the particular device in an appropriate manner to monitor the patient and can assure that the intended effect is achieved; and

3.           The device is designed for home use rather than for clinical use.


DME PROVIDERS

DME AND MD PRESCRIPTION REQUIREMENTS

Our regulations require that all durable medical equipment and supplies be recommended by an MD for consideration of Medicaid authorization to purchase or rent.

The Prior Authorization Unit at Paramax will accept and process requests for DME supplies submitted on a PA01 request form or doctor's order forms when provider-designed equipment list forms are attached and signed by the prescribing physician in lieu of a signed prescription.

Providers who do not have predesigned equipment list forms should continue to attach the physician's prescription or his letterhead copy to the PA01.


WHEELCHAIRS

DME providers may now submit requests for special or customized type wheelchairs for residents of nursing homes and mental retardation facilities, who are both Medicaid and Medicare Part B eligible, to the Unisys/Paramax Prior Authorization Unit for review since Medicare does not cover wheelchairs for LTC residents.  It is not necessary to bill Medicare first.

In addition, the Prior Authorization Unit may now review requests for special or customized wheelchairs for residents of nursing homes (ICF I, II, and SNF), who receive only Medicaid benefits because nursing homes are no longer required to furnish all wheelchairs for their residents.  Under the revised LTC standards for payment for ICF I, II, and SNF nursing homes, these facilities are only required to furnish standard type wheelchairs.


HOSPITALS, PHYSICIANS AND DME PROVIDERS

REQUESTING APPROVAL

Provided below are the procedures providers must follow to request the approval of any outpatient surgery done on an inpatient basis and to request an extension of hospital days.  All of these requests must be submitted on a PA01 form.  We have included sample PA01 forms in the Attachments section of this issue of the Provider Update, and we have starred the required items for each type of request.

I.             Physicians (or other professional services providers) requesting authorization for outpatient surgery done on an inpatient basis must use the Prior Authorization request form (PA01).  This form replaces the form 158C.  In addition, to expedite the review process, providers must continue to attach the appropriate medical data to substantiate the need for the service being provided.  Any extenuating circumstances should be submitted along with the request.

Providers should follow the instructions listed below when completing the PA01.

NOTE:  See the sample PA01 form provided.  The required items have been starred.

1.            In the block entitled Prior Authorization Type, check the last square, 99 other.

2.            Enter the recipient's Medicaid identification number in the block entitled Recipient ID Number exactly as the number appears on the recipient's Medicaid identification card.

3.            Enter the recipient's last name, first name, and middle initial in the block entitled Recipient Last Name First MI exactly as the name appears on the recipient's Medicaid identification card.

4.            Enter the seven-digit Medicaid provider number of the individual physician making the request in the block entitled Provider Number.

                  NOTE:  Do not enter the provider's group number; enter only the individual attending physician's number.

5.            In the block entitled Dates of Service, enter the anticipated dates of hospitalization in month, day, year format (MMDDYY).  If requesting post authorization, enter the exact date of the surgery performed in the same format (MMDDYY).

6.            In the block entitled Diagnosis, enter he ICD-9-CM diagnosis code for the primary diagnosis in the square entitled Primary Code and Description.  If applicable, enter the ICD-9-CM diagnosis code for the secondary diagnosis in the square entitled Secondary Code and Description.  In addition, be sure to include a narrative description of each code listed.

7.            In the space provided under the block entitled Procedure Code, enter the current CPT-4 code for the procedure that is to be performed, and in the space provided under the block entitled Description, enter the appropriate description of the procedure code you entered.

8.            In the block entitled Provider Name, Address, Telephone, enter the provider's name, address, and telephone number.

9.            In the block entitled Date of Request, enter the date the request is being made.

10.        On the line entitled Provider Signature at the bottom of the PA01 form, please ensure that the request is signed by the provider of service or another authorized representative.

                  NOTE:  We will accept stamped or computer-generated signatures if they are initialed by the provider.

II.             Hospitals requesting authorization for outpatient surgery done on an inpatient basis must use the Prior Authorization request form (PA01).  This form replaces form 158C.  In addition, to expedite the review process, providers must continue to attach the appropriate medical data to substantiate the need for the service being provided.  Any extenuating circumstances should be submitted along with the request.

         Providers should follow the instructions listed below when completing the PA01.

         NOTE:  See the sample PA01 form provided.  The required items have been starred.

  1. In the block entitled Prior Authorization Type, check the last square, 01 Inpatient.

  2. Enter the recipient's Medicaid identification number in the block entitled Recipient ID Number exactly as the number appears on the recipient's Medicaid identification card.

  3. Enter the recipient's last name, first name, and middle initial in the block entitled Recipient Last Name First MI exactly as the name appears on the recipient's Medicaid identification card.

  4. Enter the seven-digit Medicaid provider number in the block entitled Provider Number.

  5.  In the block entitled Dates of Service, enter the anticipated dates of hospitalization in month, day, year format (MMDDYY).  If requesting  post authorization, enter the exact date of the surgery performed in the same format (MMDDYY).

  6. In the block entitled Diagnosis, enter the ICD-9-CM diagnosis code for the primary diagnosis in the square entitled Primary Code and Description. If applicable, enter the ICD-9-CM diagnosis code for the secondary diagnosis in the square entitled Secondary Code and Description.  In addition, be sure to include a narrative description of each code listed.

  7.  In the space provided under the block entitled Procedure Code, enter the current ICD-9-CM code for the procedure that is to be performed, and in the space provided under the block entitled Description, enter the   appropriate description of the procedure code you entered.

  8. In the block entitled Provider Name, Address, Telephone, enter the provider's name, address, and telephone number.

  9.   In the block entitled Date of Request, enter the date the request is being made.

  10. On the line entitled Provider Signature at the bottom of the PA01 form,  please ensure that the request is signed by the provider of service or another authorized representative.

NOTE:  We will accept stamped or computer-generated signatures if they are initialed by the provider.

III.           Hospitals requesting authorization for an extension of inpatient days must use the Prior Authorization request form (PA01).  This form replaces from 110H.E.  In addition, to expedite the review process, providers must continue to attach the appropriate medical data to substantiate the need for the service being provided.  Any extenuating circumstances should be submitted along with the request.

         Providers should follow the instructions listed below when completing the PA01.

         NOTE:  See the sample PA01 form provided.  The required items have been starred.

1.            In the block entitled Prior Authorization Type, check the first square entitled 01 Inpatient.

2.           Enter the recipient's Medicaid identification number in the block entitled Recipient ID Number exactly as the number appears on the recipient's Medicaid identification card.

3.            Enter the recipient's last name, first name, and middle initial in the block entitled Recipient Last Name First MI exactly as the name appears on the recipient's Medicaid identification card.

4.            Enter the seven-digit Medicaid provider number in the block entitled Provider Number.

5.            In the block entitled Dates of Service, enter the anticipated From and Thru dates of the inpatient hospitalization covered by the request.

6.            In the block entitled Inpatient Ext, check "Yes," and enter the total days requested on the line provided.

7.            In the block entitled Diagnosis, enter the ICD-9-CM diagnosis code for the primary diagnosis in the square entitled Primary Code and Description.  If applicable, enter the ICD-9-CM diagnosis code for the secondary diagnosis in the square entitled Secondary Code and Description.  In addition, be sure to include a narrative description of each code listed.

8.            In the block entitled Provider Name, Address, Telephone, enter the provider's name, address, and telephone number.

9.            In the block entitled Date of Request, enter the date the request is being made.

10.         On the line entitled Provider Signature at the bottom of the PA01 form, please ensure that the request is signed by the provider of service or another authorized representative.

NOTE:  We will accept stamped or computer-generated signatures if they are initialed by the provider.

IV.           Hospitals requesting both a 158C and 110H.E. at the same time should follow the procedures listed in the following column when completing the PA01 form.

NOTE:  See the sample PA01 form provided.  The required items have been starred.

  1. In the block entitled Prior Authorization Type, check the last square, 01 Inpatient.

  2. Enter the recipient's Medicaid identification number in the block entitled Recipient ID Number exactly as the number appears on the recipient's Medicaid identification card.

  3. Enter the recipient's last name, first name, and middle initial in the block entitled Recipient Last Name First MI exactly as the name appears on the recipient's Medicaid identification card.

  4. Enter the seven-digit Medicaid provider number in the block entitled Provider Number.

  5. In the block entitled Dates of Service enter the anticipated From and Thru dates of the inpatient hospitalization covered by the request

  6. In the block entitled Inpatient Ext, check "Yes," and enter the total days requested on the line provided.

  7. In the block entitled Diagnosis, enter the ICD-9-CM diagnosis code for the primary diagnosis in the square entitled Primary Code and Description.  If applicable, enter the ICD-9-CM diagnosis code for the secondary diagnosis in the square entitled Secondary Code and Description.  In addition, be sure to include a narrative description of each code listed.
     

  8. In the space provided under the block entitled Procedure Code, enter the current ICD-9-CM code for the procedure that is to be performed, and in the space provided under the block entitled Description, enter the appropriate description of the procedure code you entered.

  9. In the block entitled Provider Name, Address, Telephone, enter the provider's name, address, and telephone number.

  10. In the block entitled Date of Request, enter the date the request is being made.

  11. On the line entitled Provider Signature at the bottom of the PA01 form, please ensure that the request is signed by the provider of service or another authorized representative.

                  

NOTE:  We will accept stamped or computer-generated signatures if they are initialed by the provider.

V.             Once the review process has been completed and the request has been approved or denied, the provider of services and the recipient will receive written notification informing them of the results.

If the request is approved, the providers should submit the appropriate claim form and enter the nine-digit prior authorization number in the appropriate block on the claim form.  The PA number should be entered in Item #23B on the HCFA 1500 claim form and in Item #91 on the UB-82 claim form.

If the request is denied, providers should follow the instructions that were provided in the August 1991 Provider Update.

VI.           Physicians requesting an extension of outpatient visits should continue to use the BHSF form 158-A.  In addition, physicians should attach the 158-A to the claim form if the request is approved.