RA Messages for February 19, 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
ATTENTION ALL PROVIDERS
2008 HCPCS UPDATE COMPLETE
THE 2008 HCPCS CODES HAVE BEEN LOADED
TO THE LOUISIANA MEDICAID FILES AND MAY NOW BE SUBMITTED FOR DATES OF
SERVICE JANUARY 1, 2008 FORWARD. LOOK FOR THE UPDATED PROFESSIONAL
SERVICES FEE SCHEDULE ON THE LOUISIANA MEDICAID WEBSITE,
WWW.LAMEDICAID.COM. CLAIMS DENIED
DUE TO USE OF NEW 2008 CODES PRIOR TO THEM BEING ADDED TO OUR SYSTEM
WILL BE RECYCLED AND APPEAR ON THE RA OF 2/19/08.
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.
ATTENTION PROFESSIONAL SERVICES PROVIDERS
"CRITICAL CARE SERVICES"
PROFESSIONAL SERVICES PROVIDERS
SUBMITTING CLAIMS FOR CRITICAL CARE SERVICES (TO INCLUDE ADULT,
PEDIATRIC, AND NEONATAL CRITICAL CARE AND INTENSTIVE SERVICES) SHOULD
REFER TO THE CURRENT PROCEDURAL TERMINOLOGY (CPT) MANUAL FOR DIRECTION
AND THE MOST CURRENT DESCRIPTION OF PROCEDURES AND SERVICES INCLUDED IN
THE CRITICAL CARE SERVICES CODES. CURRENT CRITICAL CARE CODE RANGES THAT
INCLUDE SERVICES THAT SHOULD NOT BE REPORTED SEPARATELY INCLUDE:
99291-99292, 99293-99300, 99477. IF NATIONALLY APPROVED CHANGES OCCUR TO
CPT CODES AT A FUTURE DATE THAT RELATE TO CRITICAL CARE SERVICES,
PROVIDERS ARE TO FOLLOW THE MOST ACCURATE CODING AVAILABLE FOR THE
PARTICULAR DATE OF SERVICE, UNLESS DIRECTED OTHERWISE.
PAYMENTS TO PROVIDERS FOR SERVICES
INCLUDED IN THE CRITICAL CARE PROCEDURES CODES AS DEFINED BY CPT ARE
SUBJECT TO POST PAYMENT REVIEW AND RECOVERY OF OVERPAYMENTS.
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.