RA Messages for October 21, 2003
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.
ATTN: PHARMACY PROVIDERS
PLEASE MAKE THE FOLLOWING CHANGES TO THE 1/1/02 VERSION OF APPENDIX A:
| DRUG |
DOSAGE |
STRGTH |
MAC |
EFF DATE |
| ASPIRIN/CAFFEINE/BUTALBITAL |
TABLET |
325-40-50 |
.24000 |
11/02/03 |
| FLUOCINOLONE ACETONIDE 60ML |
SOL |
0.01% |
.17999 |
11/02/03 |
| GRISEOFULVIN ULTRAMICROSIZE |
TABLET |
250MG |
OFF MAC |
10/01/03 |
| IPRATROPIUM BROMIDE |
SOL |
0.2MG/ML |
.23400 |
11/02/03 |
| LOVASTATIN |
TABLET |
40MG |
3.20120 |
11/02/03 |
| PINDOLOL |
TABLET |
5MG |
.69300 |
11/02/03 |
| PINDOLOL |
TABLET |
10MG |
.93520 |
11/02/03 |
| PROCAINAMIDE HCL |
CAPSULE |
500MG |
OFF MAC |
10/01/03 |
| PROPOXYPHENE/ACETAMINOPHEN |
TABLET |
100-65MG |
.18000 |
11/02/03 |
ATTENTION PHARMACY PROVIDERS
PLEASE MAKE THE FOLLOWING CHANGES TO THE 1/1/02 VERSION OF
APPENDIX C:
| LABELER |
COMPANY |
BEGIN |
END |
| 59879 |
PECOS PHARMACEUTICAL |
|
01/01/04 |
| 67781 |
PURDUE PHARMACEUTICAL PRODUCTS |
01/01/04 |
|
| 68249 |
CAROLINA PHARMACEUTICALS INC |
01/01/04 |
|
ATTENTION PRESCRIBING PROVIDERS AND PHARMACY
PROVIDERS
THIS IS A CORRECTION TO THE PDL/PA INFORMATION FOR ZYRTEC SYRUP
ON PAGE 1 OF THE MOST RECENT PDL LIST SENT TO YOU SEPTEMBER 12, 2003 WITH AN
OCTOBER 1, 2003 EFFECTIVE DATE. THE INFORMATION SHOULD READ AS FOLLOWS:
PDL - CETIRIZINE SYRUP (ZYRTEC SYRUP) - CHILDREN 12 YEARS AND
UNDER
REQUIRES PA - CETIRIZINE SYRUP (ZYRTEC SYRUP) - PERSON OVER 12
YEARS OLD
THE LOUISIANA MEDICAID WEBSITE HAS BEEN UPDATED TO REFLECT THIS
CHANGE.
PHARMACY PROVIDERS, PLEASE NOTE:
WITH THE IMPLEMENTATION OF HIPAA, PLEASE BE ADVISED THAT
PHARMACY PROVIDERS ARE TO CONTINUE BILLING SUPPLIES, WHICH ARE REIMBURSABLE IN
THE MEDICAID PHARMACY PROGRAM, THROUGH THE POINT OF SALE SYSTEM USING NCPDP
5.1. THE DEPARTMENT WILL ADVISE PROVIDERS OF ANY CHANGES IN THE BILLING OF
SUPPLIES.
HOME AND COMMUNITY-BASED WAIVER SERVICES
FOR INFORMATION ABOUT HOME AND COMMUNITY-BASED WAIVER SERVICES AS AN
ALTERNATIVE LONG TERM CARE OPTION, PLEASE CALL 1-800-660-0488.
ATTENTION PROVIDERS OF ANESTHESIA SERVICES
THE REVISED ANESTHESIA POLICY WHICH WAS DISTRIBUTED TO YOU DATED
SEPTEMBER 26, 2003 CONTAINS AN ERROR. THE NOTE THAT APPEARS AT THE BOTTOM
OF PAGE 6 APPLIES TO THE MATERNITY-RELATED INFORMATION PRESENTED ON PAGES 5 AND
6 ONLY. IT DOES NOT APPLY TO THE MATERNITY-RELATED INFORMATION CONTAINED
ON PAGE 4 OF THE DOCUMENT. PLEASE MAKE A CORRECTION TO THE INFORMATION YOU
RECEIVED TO REFLECT THIS CHANGE.
ATTENTION LTC/ADHC/ICF-MR/HOSPICE PROVIDERS
EFFECTIVE OCTOBER 1, 2003, ALL CLAIM ADJUSTMENTS SUBMITTED ON
THE UB-92 OR 148 PLI MUST BE SUBMITTED USING THE HIPAA STANDARD 2 DIGIT PATIENT
STATUS CODES. THESE CODES MUST BE USED FOR ALL DATES OF SERVICE, FOR A
COMPLETE LIST OF ALLOWABLE PATIENT STATUS CODES, PLEASE SEE THE LTC BILLING
INSTRUCTIONS DOCUMENT ON THE HIPAA BILLING INSTRUCTIONS & COMPANION GUIDES
PAGE OF THE LAMEDICAID.COM WEB SITE. ALL ALLOWABLE VALUES ARE LISTED FOR
FIELD 22 - PATIENT STATUS.
ATTENTION PROVIDERS OF PROFESSIONAL SERVICES
CLAIMS THAT INCORRECTLY DENIED FOR ERROR EDITS 670 AND 671 IN
THE OCTOBER 7, 2003 REMIT CYCLE ARE BEING RECYCLED AND PAID IN THE OCTOBER 28,
2003 REMIT CYCLE.
ATTENTION DENTAL PROVIDERS
A SYSTEMS ENHANCEMENT CAUSED SOME DENTAL CLAIMS SUBMITTED
ELECTRONICALLY FROM OCTOBER 7 THROUGH OCTOBER 14 TO GO UNPROCESSED. THE PROBLEM
HAS BEEN IDENTIFIED AND ALL CLAIMS ARE BEING REPROCESSED FOR ADJUDICATION
ON THE OCTOBER 28, 2003 REMITTANCE ADVICE. WE APOLOGIZE FOR ANY INCONVENIENCE
THIS MAY CAUSE YOU. PLEASE CONTACT UNISYS PROVIDER RELATIONS AT (800) 473-2783
IF YOU HAVE QUESTIONS.