ATTENTION
PROVIDERS OF RUM SERVICES
With the implementation of Bayou Health, RUM
authorizations were being rejected back to MSI if the authorization
period overlapped the Bayou Health effective date for the recipient.
This caused claims to deny, also. MSI has retransmitted the
majority of the rejected authorizations, but there are still some
outstanding. On this RA (08/14/12), Molina has recycled claims
that were denied for edit 190 (no PA) for dates of service 02/01/12
forward in an attempt to allow any claims to process where the
authorization has been successfully received from MSI. Since some
authorizations are still outstanding, only claims with approved and
successfully re-transmitted authorizations were recycled to process
through the system. Some of these claims will deny again for
appropriate edits other than edit 190. Hopefully, this will allow
payment of many claims involved and let providers know the status of
those not recycled. Once all authorizations are successfully
re-transmitted, a final claims recycle will occur. We apologize for the
inconvenience this has caused providers.
NOTICE TO ALL PHYSICIANS PROVIDERS
CONSULTATION CODES ARE NO LONGER BILLABLE
Effective July 1, 2012, Medicaid will no longer recognize
office and other outpatient consultation codes (99241-99245) and inpatient consultation codes
(99251-99255).
With date of services July 1, 2012 physicians should adhere
to current concurrent care-inpatient policy as outlined in the Professional
Service Manual, section 5.1. Providers should bill the appropriate subsequent
hospital care code when rendering these services in the hospital setting. Only
the admitting provider may submit a claim for one of the initial hospital care
codes per a recipient's inpatient stay. Therefore use of the AI modifier when
billing the appropriate E/M codes for the services rendered will not be
necessary.