RA Messages for November 06, 2007
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
ATTENTION MENTAL HEALTH CLINIC
PROVIDERS
PROCEDURE CODE 96100 FOR PSYCHOLOGICAL
TESTING IS OBSOLETE EFFECTIVE 11/01/07. ON 11/01 BILL CODE 96101
PSYCHOLOGICAL TESTING BY PSYCHOLOGIST OR PHYSICIAN. ONLY ONE PROCEDURE
PER RECIPIENT PER YEAR MAY BE BILLED.
ATTENTION PROFESSIONAL SERVICE
PROVIDERS
"PSYCHIATRIC SERVICES"
EFFECTIVE WITH DATE OF SERVICE OCTOBER 1, 2007, LOUISIANA MEDICAID
REIMBURSES FOR SELECT PROCEDURE CODES SPECIFIC TO OUTPATIENT PSYCHIATRIC
SERVICES. DETAILED POLICY INFORMATION WILL BE FORTHCOMING. PROVIDERS ARE
ASKED TO HOLD CLAIMS FOR THESE SERVICES UNTIL NOTIFIED BY THE DEPARTMENT
AS PROGRAMMING IS NOT YET COMPLETE. IT IS ANTICIPATED THAT THE SYSTEM
CHANGES WILL BE IN PLACE IN THE NEAR FUTURE. PLEASE MONITOR FUTURE RA
MESSAGES WHICH WILL INFORM PROVIDERS WHEN THESE CLAIMS MAY BE SUBMITTED.
ATTENTION DENTAL PROVIDERS
EFFECTIVE FOR DATES OF SERVICE ON AND AFTER NOVEMBER 1, 2007, CERTAIN
MEDICAID-COVERED EPSDT DENTAL, EXPANDED DENTAL SERVICES FOR PREGNANT
WOMEN (EDSPW), AND ADULT DENTURE PROGRAM SERVICES WILL RECEIVE A
REIMBURSEMENT RATE INCREASE; AND CERTAIN EPSDT DENTAL PROGRAM POLICY
REVISIONS WILL BE IMPLEMENTED. REIMBURSEMENT MAY BE DELAYED (AND APPLIED
RETROACTIVELY) DUE TO NECESSARY PROGRAMMING CHANGES. COMPLETE DETAILS
WILL BE PLACED ON THE
WWW.LAMEDICAID.COM WEBSITE UNDER THE "NEW MEDICAID INFORMATION" AND
"FEE SCHEDULE" LINKS PRIOR TO NOVEMBER 1, 2007. IF YOU HAVE QUESTIONS,
YOU MAY CONTACT THE LSU DENTAL MEDICAID UNIT AT 504-941-8206 OR
1-866-263-6534 (TOLL FREE).
ATTENTION EDI SUBMITTERS
THE 2008 EDI ANNUAL CERTIFICATION FORMS HAVE BEEN MAILED. THE FORM IS
ALSO LOCATED ON WWW.LAMEDICAID.COM
UNDER EDI INFO. PLEASE COMPLETE AND RETURN THE 2008 ANNUAL CERTIFICATION
FORM TO THE UNISYS EDI DEPARTMENT BY DECEMBER 31, 2007 TO AVOID CLOSURE
OF YOUR SUBMITTER NUMBER, WHICH WILL RESULT IN YOUR FILE BEING DROPPED
WITHOUT BEING PROCESSED.