RA Messages for November 13, 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PROCEDURE CODE 96100 FOR PSYCHOLOGICAL TESTING IS OBSOLETE EFFECTIVE 11/01/07.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.

ATTENTION PROVIDERS ADMINISTERING IMMUNIZATIONS

IMMUNIZATION ADMINISTRATION CURRENT PROCEDURAL TERMINOLOGY (CPT) CODES 90465-90648, 90473, AND 90474 HAVE BEEN MADE PAYABLE AND ADDED TO THE CURRENT CLAIMS PROCESSING SYSTEM. PROVIDERS SHOULD REFER TO THE CPT CODE DESCRIPTION TO DETERMINE THE APPROPRIATE CODE FOR THE ADMINISTRATION OF A VACCINE. UPDATED INFORMATION REGARDING USE OF THESE CODES CAN BE FOUND IN THE 2007 PROVIDER TRAINING MATERIALS FOR KIDMED AND PROFESSIONAL SERVICES. PREVIOUSLY DENIED CLAIMS FOR THESE IMMUNIZATION ADMINISTRATION CODES WILL BE RECYCLED FROM DATE OF SERVICE JANUARY 1, 2006 FORWARD. PROVIDERS WILL BE NOTIFIED BY RA MESSAGES WHEN THIS IS COMPLETE.

ATTENTION PROFESSIONAL SERVICES PROVIDERS "ADULT IMMUNIZATIONS"

EFFECTIVE WITH DATE OF SERVICE OCTOBER 1, 2007, LOUISIANA MEDICAID REIMBURSES FOR IMMUNIZATIONS (VACCINE AND ADMINISTRATION) TO RECIPIENTS AGE 21 YEARS AND OLDER FOR INFLUENZA, PNEUMOCOCCAL, AND HUMAN PAPILLOMAVRIUS (HPV) DISEASES. 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.