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. Participation may be verified in Appendix C, available at
http://www.lamedicaid.com.
Should you have any questions
regarding any of the following messages, please contact Molina Medicaid
Solutions at (800) 473-2783 or (225) 924-5040.
2017 Assistant Surgeon and Assistant at Surgery Covered Procedures – Revised May 2017
Louisiana Medicaid has republished the 2017 fee-for-service list of allowed procedures for assistant surgeons and assistant at surgery providers. Changes were made to better align with national coding standards and fee-for-service coverage of surgical procedures.
The updated 2017 list has been reposted to the LA Medicaid website (www.lamedicaid.com) under the ‘ClaimCheck’ icon titled, “2017 Assistant Surgeon and Assistant at Surgery List of Covered Procedure Codes – Revised May 2017.” Some procedure codes have been marked out (ex. 22842), as they do not require the services of an assistant surgeon.
This list does not ensure payment but provides a comprehensive list of codes that may be allowed when billed by an assistant surgeon or by an assistant at surgery.
Please contact the appropriate Managed Care Organization with any questions concerning their updates. For questions related to this information as it pertains to fee-for-service Medicaid claims processing, please contact Molina Medicaid Solutions Provider Services at (800) 473-2783 or (225) 924-5040.