RA Messages for February 11, 2008
PHARMACY PROVIDERS, PLEASE
NOTE!!!
IF YOU ARE UNSURE ABOUT THE COVERAGE OF A DRUG PRODUCT, PLEASE CONTACT
THE PBM HELP DESK AT 1-800-648-0790.
PLEASE FILE ADJUSTMENTS FOR CLAIMS THAT MAY HAVE BEEN INCORRECTLY PAID.
ONLY THOSE PRODUCTS OF THE MANUFACTURERS WHICH PARTICIPATE IN THE
FEDERAL REBATE PROGRAM WILL BE COVERED BY THE MEDICAID PROGRAM. PARTI-
CIPATION MAY BE VERIFIED IN APPENDIX C, AVAILABLE AT
WWW.LAMEDICAID.COM
ALL PROVIDERS
2008 HCPCS UPDATE
LOUISIANA MEDICAID IS IN THE PROCESS OF COMPLETING THE PROGRAMMING FOR
THE 2008 HCPCS CODE UPDATES. THIS INCLUDES BOTH NEW AND DELETED CODES
FOR 2008. PROVIDERS SHOULD MONITOR FUTURE RA MESSAGES FOR NOTIFICATION
OF THE IMPLEMENTATION DATE FOR USE OF THE NEW 2008 HCPCS CODES.
ORTHOTIC AND PROSTHETIC PROVIDERS
THE BUREAU OF HEALTH SERVICES
FINANCING IS PLEASED TO ANNOUNCE THAT WE HAVE INCREASED THE
REIMBURSEMENT RATE FOR ORTHOTIC AND PROSTHETIC DEVICES TO NINETY PERCENT
OF THE 2007 MEDICARE FEE SCHEDULE. THIS INCREASE IS EFFECTIVE BEGINNING
WITH THE DATE OF SERVICE SEPT. 6, 2007. IF YOU DID NOT SEE AN ADJUSTMENT
OF PAYMENTS MADE AT THE OLD AMOUNT ON THE CHECK WRITE OF DECEMBER 26,
2007, YOU MUST SUBMIT AN ADJUSTMENT CLAIM TO UNISYS IN ORDER TO RECEIVE
THE ADDITIONAL PAYMENT.
URGENT: ATTENTION PROVIDERS AND BILLING VENDORS
RE: FEDERAL STATUTE
REQUIRING THE USE OF NATIONAL DRUG CODE (NDC) FOR PHYSICIAN ADMINISTERED
DRUGS
EFFECTIVE MARCH 1, 2008, PROVIDERS
WILL BE REQUIRED TO SUBMIT NDC NUMBERS AND THE HCPCS CODE FOR PHYSICIAN
ADMINISTERED DRUGS ON THE 837P AND THE CMS-1500 CLAIM FORMS.
NON-COMPLIANT CLAIMS WILL RESULT IN DENIALS. PROVIDERS AND BILLING
VENDORS MUST IMMEDIATELY BEGING UPDATING THEIR BILLING SYSTEMS. BILLING
INSTRUCTIONS CAN BE FOUND IN THE 2007 TRAINING MANUALS FOR PROFESSIONAL
SERVICES, KIDMED, AND RHC/FQHC SERVICES IN THE SECTION OF INFORMATION
PERTAINING TO THE CMS-1500 FORM.
EFFECTIVE ON OR BEFORE JUNE 30, 2008, PROVIDERS WILL BE REQUIRED TO
SUBMIT NDC NUMBERS ON THE 837I AND UB04 CLAIM FORMS. INSTRUCTIONS ON
BILLING THE NDC NUMBERS ON THESE CLAIMS FORMS WILL BE PUBLISHED IN THE
NEAR FUTURE. PLEASE CONTINUE TO MONITOR RA MESSAGES AND THE
WWW.LAMEDICAID.COM WEBSITE FOR UPCOMING INFORMATION.
ALL PROVIDERS
THE OFFICE OF AGING AND ADULT SERVICES
IS THE RECIPIENT OF SOCIAL SERVICES BLOCK GRANT (SSBG) FUNDS TO ASSIST
INDIVIDUALS WHO WERE AFFECTED BY HURRICANES KATRINA OR RITA. COMPLETE
INFORMATION IS AVAILABLE IN MEMO FORM ON THE OAAS WEBSITE
WWW.OAAS.DHH.LOUISIANA.GOV,
ON THE LOUISIANA MEDICAID WEBSITE WWW.LAMEDICAID.COM AND THE DEPARTMENT
OF HEALTH AND HOSPITALS WEBSITE WWW.DHH.LOUISIANA.GOV.