RA Messages for October 5, 1999
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
MAKE THE FOLLOWING CHANGES TO THE 8/15/98 VERSION OF APPENDIX A:
| DRUG |
DOSAGE |
STRGTH |
MAC |
EFF.DATE |
| BUTOCONAZOLE NITRATE |
CRM/PF APP |
20% |
|
10/01/99 |
| CALFACTANT |
VIAL |
35MG/ML |
|
08/24/99 |
| ERYTHROMYCIN ESTOLATE |
CAPSULE |
250MG |
OFF MAC |
10/04/99 |
| FOLIC ACID |
TABLET |
1MG |
$0.03750 |
10/04/99 |
| IBUPROFEN |
TABLET
|
400MG
|
$0.16160 |
10/04/99 |
| IBUPROFEN |
TABLET |
600MG |
$0.22658 |
10/04/99 |
| IBUPROFEN |
TABLET |
800MG |
$0.29020 |
10/04/99 |
| LIDOCAINE |
ADH PATCH |
5% |
|
09/15/99 |
| LINDANE |
LOTION |
1% 60'S |
$0.09983 |
10/04/99 |
| LINDANE |
LOTION |
1% OTH SIZES |
OFF MAC |
10/04/99 |
| LINDANE |
SHAMPOO |
1% 60'S |
$0.09983 |
10/04/99 |
| LINDANE |
SHAMPOO |
1% OTH SIZES |
OFF MAC |
10/04/99 |
| MINOXIDIL |
TABLET |
2.5MG |
$0.33250 |
10/04/99 |
| MINOXIDIL |
TABLET |
10MG |
$0.54000 |
10/04/99 |
| ONDANSETRON HCL |
TABLET |
24MG |
|
09/20/99 |
| PIOGLITAZONE HCL |
TABLET |
15MG;30MG;45MG |
|
10/01/99 |
| PIROXICAM |
CAPSULE |
10MG |
$1.25750 |
10/04/99 |
| PIROXICAM |
CAPSULE |
20MG |
$2.15190 |
10/04/99 |
| RANITIDINE HCL |
TABLET |
150MG |
$1.47150 |
10/04/99 |
| RANITIDINE HCL |
TABLET |
300MG |
$2.56672 |
10/04/99 |
| VALPROIC ACID |
CAPSULE |
250MG |
$0.59000 |
10/04/99 |
| ZALEPLON |
CAPSULE |
5MG;10MG |
|
08/20/99 |
PLEASE
MAKE THE FOLLOWING CHANGES TO THE 8/15/98 VERSION OF APPENDIX C:
| LABELER |
COMPANY |
BEGIN |
END |
| 11845 |
MASON DISTRIBUTORS,
INCORPORATED |
|
10/01/99 |
| 64764
|
TAKEDA PHARMACEUTICALS AMERICA
|
10/01/99 |
|
| 64909 |
ZOETICA PHARMACEUTICAL CORPORATION |
10/01/99 |
|
PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN
INCORRECTLY PAID
PHARMACY PROVIDERS
POS CLAIMS SUBMITTED WITH THE 16 DIGIT CARD HOLDER NUMBER (CCN)
AND A '2' IN THE 'ELIGIBILITY
OVERRIDE CLARIFICATION CODE' FIELD WILL DENY WITH
EDIT 215.
PHARMACISTS AND PHYSICIANS
NOTE: MEDICARE REQUIRES PHYSICIANS TO PROVIDE ICD-9
DIAGNOSIS CODES ON ALL CERTIFICATES OF MEDICAL NECESSITY. ONLY ICD-9 CODES ARE
ACCEPTABLE. THERE IS NO PROVISION FOR NARRATIVE DIAGNOSIS. THEREFORE,
EFFECTIVE FOR DATES OF SERVICE 10/01/99, LOUISIANA MEDICAID WILL ONLY ACCEPT
ICD-9 DIAGNOSIS CODES TO BE
CONSISTENT WITH MEDICARE POLICY. ANY ORIGINAL PRESCRIPTION
BILLED PRIOR TO 10/01/99 WITH REFILLS REMAINING WILL HAVE PAYMENTS FOR THOSE
REFILLS GRANDFATHERED IF THE NARRATIVE DIAGNOSIS IS PRESENT ON THE PRESCRIPTION
HARD-COPY OR THE ATTACHMENT. HOWEVER, AFTER THE AUTHORIZED REFILLS HAVE BEEN
EXHAUSTED, ONLY ICD-9 DIAGNOSIS CODES WILL BE THE ACCEPTABLE FORM OF
DOCUMENTATION. ANY QUESTIONS CONCERNING THIS CHANGE CAN BE DIRECTED TO THE POS
HELP DESK AT 1-800-648-0790 OR
(225) 237-3381.