PLEASE MAKE THE FOLLOWING CHANGES TO APPENDIX A:

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

COMMUNITYCARE/KIDMED ALERT

SOME OF THE ELECTRONIC RS-0-07 REPORTS FOR OCTOBER 2006 WERE INCORRECT. PROVIDERS WHO DOWNLOADED THEIR REPORTS FROM THE TAB FILE SHOULD DISCARD THOSE REPORTS.THE CORRECT REPORTS ARE NOW AVALILABLE. THERE WAS NO PROBLEM WITH THE REPORTS DOWNLOADED FROM THE PDF FILE.

ATTENTION MENTAL HEALTH CLINIC PROVIDERS

PROCEDURE CODE 90782 FOR INJECTIONS WILL BE OBSOLETE EFFECTIVE 11/1/06. FOR DATES OF SERVICE BEGINNING 11/1/06, PLEASE BILL CODE 90772.

ATTENTION MENTAL HEALTH REHABILITATION PROVIDERS

PROCEDURE CODE 90782 FOR INJECTIONS HAS BEEN MADE OBSOLETE. FOR PRIOR AUTHORIZATION REQUESTS BEGINNING 10/1/06 AND EXTENDING BEYOND 12/31/06, THE AUTHORIZATIONS FOR CODE 90782 WILL BE CANCELLED AND REISSUED IN CODE 90772. YOU MAY CONTINUE TO BILL 90782 FOR SERVICE AUTHORIZATION PERIODS WHICH BEGAN PRIOR TO 10/1/06 AND END 12/31/06 OR BEFORE.

ATTENTION PSYCHOLOGICAL AND BEHAVIORAL SERVICES PROVIDERS

PROCEDURE CODE 96100 FOR PSYCHOLOGICAL TESTING IS OBSOLETE EFFECTIVE 11/1/06. BEGINNING 11/1/06 BILL CODE 96101 PSYCHOLOGICAL TESTING BY PSYCHOLOGIST OR PHYSICIAN. THE RATE FOR THIS PROCEDURE HAS BEEN INCREASED TO $74.69 PER UNIT UP TO A MAXIMUM OF 8 UNITS. ONLY ONE PROCEDURE PER RECIPIENT PER YEAR MAY BE BILLED BY A PROVIDER/GROUP.

ATTENTION DENTAL PROVIDERS

EFFECTIVE 11/1/06, CERTAIN SERVICES IN THE EPSDT DENTAL, ADULT DENTURE AND EXPANDED DENTAL SERVICES FOR PREGNANT WOMEN PROGRAMS WILL RECEIVE RATE INCREASES. ALSO, SEVERAL ADDITIONAL SERVICES WILL BE MADE PAYABLE AND POLICY REVISIONS RELATED TO SEVERAL EXISTING DENTAL SERVICES WILL OCCUR. COMPLETE INFORMATION REGARDING THE RATE INCREASES, NEW ADDITIONAL CODES AND POLICY REVISIONS WILL BE PLACED ON THE FOLLOWING WEBSITE PRIOR TO 11/1/06: WWW.LAMEDICAID.COM(LINKS ENTITLED "NEW MEDICAID INFORMATION" "BILLING INFORMATION" AND "FEE SCHEDULES.") MEDICAID WILL WORK DILIGENTLY TO ENSURE THAT ALL CHANGES ARE IN PLACE BY 11/1/06. HOWEVER, IN THE EVENT THAT A DELAY IS UNAVOIDABLE, WE REMIND YOU THAT DENTAL PROVIDERS ARE REQUIRED BY MEDICAID TO BILL THEIR USUAL AND CUSTOMARY FEES. PROVIDERS WHO BILL THEIR USUAL AND CUSTOMARY FEELS WILL NOT BE REQUIRED TO MANUALLY ADJUST THEIR CLAIMS SHOULD A CLAIM RECYCLE BE REQUIRED AS MEDICAID WILL AUTOMATICALLY ADJUST THE CLAIMS. IF A DENTAL PROVIDER DOES NOT BILL THEIR USUAL AND CUSTOMARY FEES AND A CLAIM RECYCLE IS REQUIRED, THE DENTAL PROVIDER WILL BE RESPONSIBLE FOR ALL NECESSARY CLAIM ADJUSTMENTS. SHOULD YOU HAVE ANY QUESTIONS RELATED TO THIS MATTER, YOU MAY CONTACT UNISYS PROVIDER RELATIONS BY CALLING (800)473-2783 OR (225)924-5040.

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.

ATTENTION PROFESSIONAL SERVICES PROVIDERS

IMPLEMENTATION OF THE PHYSICIAN SERVICES REIMBURSEMENT RATE INCREASE FOR OUTPAITENT 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.
RELATED SERVICES ARE SUBJECT TO RECOUPMENT.