RA Messages for March 04, 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 NOTE THE FOLLOWING CHANGES TO APPENDIX A:
DRUG
DOSAGE
STRGTH
MAC
EFF.
TERBUTALINE SULFATE
VIAL
1MG/ML
OFF MAC
02/25/08
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. PARTICIPATION 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 2/26/08.
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.