RA Messages for June 2, 2009

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                     DOSE       STRG        FUL       EFF    

 CARBAMAZEPINE                ORAL SUS  100MG/5ML   $0.08370  06/13/09 

 CARBAMAZEPINE                TAB CHEW   100MG      $0.20250  06/13/09 

 CILOSTAZOL                   TABLET      50MG      $0.54750  06/13/09 

 CILOSTAZOL                   TABLET     100MG      $0.54750  06/13/09 

 ISOSORBIDE MONONITRATE       TAB SR      60MG      $0.60000  06/13/09 

 LACTULOSE                    SOLUTION  10GM/15ML   $0.02210  06/13/09 

 LEVETIRACETAM                SOLUTION   100MG/ML   $0.34880  06/13/19 

 LEVETIRACETAM                TABLET     250MG      $0.43130  06/13/09 

 LEVETIRACETAM                TABLET     500MG      $0.52710  06/13/09 

 LEVETIRACETAM                TABLET     750MG      $0.71410  06/13/09 

 LEVETIRACETAM                TABLET    1000MG      $1.40720  06/13/09 

 MELOXICAM                    TABLET     7.5MG      $0.14250  06/13/09 

 MELOXICAM                    TABLET      15MG      $0.20930  06/13/09 

 MEPERIDINE HCL               TABLET      50MG      $0.31889  06/13/09 

 MEPERIDINE HCL               TABLET     100MG      $0.62930  06/13/09 

 METFORMIN HCL                TABLET     500MG      $0.07500  06/13/09 

 METFORMIN HCL                TABLET     750MG      $0.33680  06/13/09 

 METFORMIN HCL                TABLET     850MG      $0.14640  06/13/09 

 METFORMIN HCL                TABLET    1000MG      $0.16580  06/13/09 

 MINOCYCLINE HCL              TABLET      50MG      $3.00000  06/13/09 

 MINOCYCLINE HCL              TABLET      75MG      $4.44000  06/13/09 

 MINOCYCLINE HCL              TABLET     100MG      $5.25000  06/13/09 

 MIRTAZAPINE                  TABLET      15MG      $1.23000  06/13/09 

 MIRTAZAPINE                  TABLET      30MG      $1.26500  06/13/09 

 MIRTAZAPINE                  TABLET      45MG      $1.28450  06/13/09 

 TRAMADOL HCL                 TABLET      50MG      $0.90000  06/13/09 

 VERAPAMIL                    TABLET      40MG      OFF FUL   06/13/09 

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 HOSPITAL PROVIDERS OF OUTPATIENT TAKE CHARGE (FAMILY PLANNING WAIVER) SERVICES

Please note that the only codes payable in combination with HR490 (outpatient ambulatory surgery) for TAKE CHARGE recipients are 58301, 58600, 58615, 58670, and 58671. Any HCPS other than these will deny when billed in combination with HR 490.

ATTENTION INDEPENDENT LABORATORIES AND PROFESSIONAL SERVICES PROVIDERS

Updates have been made to the procedure file related to CPT codes 83913 (Molecular Diagnostics...) and 86357 (Natural Killer Cells...). A recycle of affected claims is complete and providers should see the recycled claims on the RA of May 12, 2009. No action is required by providers.

To maintain compliance with CMS guidelines in not exceeding the Medicare reimbursement rate for clinical laboratory procedures, Louisiana Medicaid's reimbursement for CPT codes 80047 (Basic Metabolic Panel...) and 82962 (Glucose, blood...) was updated effective with date of service January 1, 2009. Claims paid at the previous rate were systematically adjusted and those adjustments should appear on the RA of May 12, 2009. No action is required by providers.