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.
Should you have any questions
regarding any of the following messages, please contact Molina Medicaid
Solutions at (800) 473-2783 or (225) 924-5040.
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.