PLEASE MAKE THE FOLLOWING CHANGES TO APPENDIX A:
| DRUG |
DOSAGE |
STRGTH |
MAC |
EFF.DATE |
| ALPRAZOLAM |
TABLET |
0.5MG |
$1.93430 |
10/27/06 |
| ALPRAZOLAM |
TABLET |
1MG |
$2.40650 |
10/27/06 |
| ALPRAZOLAM |
TABLET |
2MG |
$3.19400 |
10/27/06 |
| ALPRAZOLAM |
TABLET |
3MG |
$4.79070 |
10/27/06 |
| BETHANCHOL CHLORIDE |
TABLET |
5MG |
$0.48890 |
10/27/06 |
| BETHANCHOL CHLORIDE |
TABLET |
10MG |
$0.91710 |
10/27/06 |
| BETHANCHOL CHLORIDE |
TABLET |
25MG |
$1.70790 |
10/27/06 |
| BETHANCHOL CHLORIDE |
TABLET |
50MG |
$1.95650 |
10/27/06 |
| CEFPROZIL |
OR SUSP |
125MG/5ML |
$0.40800 |
10/27/06 |
| CEFPROZIL |
OR SUSP |
250MG/5ML |
$0.73940 |
10/27/06 |
| CITALOPRAM HYDROBROMIDE |
OR SOL |
10MG/5ML |
$0.42310 |
10/27/06 |
| MELOXICAM |
TABLET |
7.5MG |
$0.21000 |
10/27/06 |
| MELOXICAM |
TABLET |
15MG |
$0.28500 |
10/27/06 |
| MINOCYCLINE HCL |
CAPSULE |
75MG |
$1.95750 |
10/27/06 |
| PRIMIDONE |
TABLET |
250MG |
$0.80550 |
10/27/06 |
| SULFAMETHOXAZOLE/TRIMETH |
TABLET |
800/160MG |
$0.37880 |
10/27/06 |
| THEOPHYLLINE |
TAB.SR |
200MG |
$0.21600 |
10/27/06 |
| THEOPHYLLINE |
TAB.SR |
300MG |
$0.26250 |
10/27/06 |
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
NATIONAL PROVIDER IDENTIFIER
DHH HAS LAUNCHED A NEW NPI WEB REGISTRATION SITE FOR PROVIDERS TO
REGISTER THEIR NPI WITH LOUISIANA MEDICAID. CMS WILL REQUIRE ALL HIPAA STANDARD
TRANSACTIONS, INCLUDING MEVS ELIGIBILITY INQUIRY AND CLAIMS STATUS INQUIRY TO
BE SUBMITTED USING THE NPI NUMBER BEGINNING 23-MAY-07. THE NEW NPI APPLICATION
IS ACCESSIBLE FROM THE LIST OF APPLICATIONS IN THE SECURED PROVIDER AREA OF THE
WWW.LAMEDICAID.COM WEB
SITE. FIND THIS AND MORE ON THE NPI INFORMATION PAGE ACCESSIBLE FROM
WWW.LAMEDICAID.COM HIPAA
INFORMATION CENTER NATIONAL PROVIDER IDENTIFIER (NPI)
ATTENTION PROVIDERS
THE OFFICE OF MANAGEMENT AND BUDGET (OMB), THE NATIONAL UNIFORM
CLAIM COMMITTEE (NUCC) AND THE NATIONAL UNIFORM BILLING COMMITTEE (NUBC) HAVE
GIVEN WITH STAMP OF APPROVAL TO THE NEW 1500 HEALTH INSURANCE CLAIM FORM
(VERSION 08/05) AND THE NEW UB-04 CLAIM FORM. THE LOGISTICS FOR DISTRI- BUTION
AND TRANSITION TO THESE REVISED FORMS, INCLUDING EFFECTIVE DATES FOR USE BY
PROVIDERS AND ACCEPTANCE BY PAYERS, IS UNDER REVIEW BY THE COMMITTEES. IT IS
VERY IMPORTANT THAT YOU DO NOT BEGIN USING THESE NEW FORMS FOR LA MEDICAID
BILLING UNTIL YOU ARE INFORMED OF THE EFFECTIVE DATE OF THE TRANSITION FOR LA
MEDICAID CLAIMS PROCESSING. YOU WILL BE KEPT INFORMED OF ALL NECESSARY
INFORMATION FOR IMPLEMENTING THESE FORMS FOR LA MEDICAID BILLING THROUGH RA
MESSAGES, NEWSLETTER ARTICLES, AND PROVIDER NOTICES POSTED ON OUR WEBSITE,
WWW.LAMEDICAID.COM .
PLEASE WATCH THESE INFORMATION AVENUES FOR THE MOST UP-TO-DATE INFORMATION FOR
BILLING LA MEDICAID.
ATTENTION PROFESSIONAL SERVICES PROVIDERS
IMPLEMENTATION OF THE PHYSICIAN SERVICES REIMBURSEMENT RATE
INCREASE FOR OUTPATIENT OFFICE EVALUATION AND MANAGEMENT SERVICES, OUTPATIENT
OFFICE CONSULTATION SERVICES, EMERGENCY DEPARTMENT SERVICES, PREVENTIVE
MEDICINE SERVICES, AND GENERAL/INTEGUMENTARY SYSTEM CPT CODES, EFFECTIVE WITH
DATE OF SERVICE OCTOBER 4, 2006, IS PENDING CMS APPROVAL. UPON APPROVAL, CLAIMS
FOR DOS OCTOBER 4, 2006 FORWARD WILL BE ADJUSTED. PROVIDERS WILL BE NOTIFIED OF
THE STATUS OF THE APPROVAL AND ADJUSTMENTS VIA FUTURE RA MESSAGES.
ATTENTION PROFESSIONAL SERVICES PROVIDERS
LOUISIANA MEDICAID DOES NOT PAY FOR SERVICES PROVIDED RELATED TO
A NON- COVERED SERVICE. AN EXAMPLE OF THIS INAPPROPRIATE BILLING SITUATION
WOULD BE FOR LOCAL ANESTHESIA PROVIDED DURING A ROUTINE CIRCUMCISION OF A
NEWBORN. NEITHER OF THESE SERVICES, IN THIS INSTANCE, IS REIMBURSABLE IN THE
LOUISIANA MEDICAID PROGRAM. PAYMENTS RECEIVED FOR NON-COVERED AND RELATED
SERVICES ARE SUBJECT TO RECOUPMENT.