RA Messages for August 05, 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. Participation may be verified in appendix c, available
at www.lamedicaid.com.
NPI - ALL PROVIDERS
On Friday, July 18th, DHH reinstated the
requirement to have a valid NPI on each claim transaction within a
submitted electronic claims file. With the exception of atypical
providers, beginning July 18th a Medicaid 7-digit legacy provider id
number can not be used in the electronic 837 Billing and Attending loops
of transactions (at this time, the referring provider loop should
contain the correct NPI and/or Medicaid 7-digit legacy provider id of
the referring provider).
Electronic claims files (837) received on or after
July 18th will no longer be rejected if the file contains a claim
transaction with a NPI error. The file will be processed and a report
will be produced for the EDI submitter of the claims to use to identify
the denied claim transactions. These reports will be available only to
EDI submitters and on www.lamedicaid.com, in the future. Submitters must
register on the website using their submitter ID number to use this
application.
If you have one NPI for one
7-digit Medicaid id number, please ensure that you are electronically
billing with that NPI. If you have one 7-digit Medicaid id number but
have registered with NPPES and received an individual NPI and an
organizational NPI, we need both numbers to process your claims. Please
review information on our website concerning reporting the individual
and organization NPI. Please note: paper claims require the 7-digit
Medicaid provider number in the appropriate fields on the claim forms.
RHC/FQHC PROVIDERS
PPS MEDICARE ECONOMIC INDEX RATE INCREASE
Effective with DOS
7/1/2008, all RHC and FQHC providers PPS rates were Increased 1.8% based
on the Medicare economic index. Errors occurred in the assignment of
these rate increases to the appropriate provider number which resulted
in incorrect PPS rates for some providers. As of 7/28/2008, all errors
in rate assignments have been corrected. Claims paid at the incorrect
rate for dos 7/1-7/28 will be systematically adjusted and providers do
not need to take any action. The department regrets any inconvenience to
providers this may have caused.
ATTENTION ALL DURABLE MEDICAL
PROVIDERS (DME)
Effective 7/1/08, Medicaid
will approve rental for the following HCPCS codes:
E1800 ADJUSTABLE ELBOW
EXT/FLEX DEVICE
E1802 ADJUSTABLE FOREARM PRO/SUP DEVICE
E1805 ADJUSTABLE WRIST EXT/FLEX DEVICE
E1810 ADJUSTABLE KNEE EXT/FLEX DEVICE
E1815 ADJUSTABLE ANKLE EXT/FLEX DEVICE
E1825 ADJUSTABLE FINGER EXT/FLEX DEVICE
E1830 ADJUSTABLE TOE EXT/FLEX DEVICE
E1840 ADJUSTABLE SHOULDER EXT/FLEX DEVICE
Effective 7/1/08, Medicaid will approve purchase for the following HCPCS
code:
E1820 SOFT INTERFACE MATERIAL