RA Messages for November 27, 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 NOTE THE FOLLOWING CHANGES TO APPENDIX C:
LABELER             COMPANY                                                                 BEGIN                         END
00086     ELAN PHARMACEUTICALS, INCORPORATED                                                     01/01/08
23589     TIBER LABORATORIES, LLC                                                 01/01/08
25010     ATON PHARMA,INC                                                              01/01/08
31722     CAMBER PHARMACEUTICALS,INC                                    01/01/08
50907     FEI PRODUCTS LLC                                                                                                   01/01/08
58291     SNUVA INCORPORATED                                                                                          01/01/08
64597     AVANIR PHARMACEUTICALS,INC                                     01/01/08
66621     RARE DISEASES THERAPEUTICS,INC                                01/01/08
67405     HARRIS PHARMACEUTICALS                                              01/01/08
67857     DR. REDDY'S LAB                                                                   01/01/08
68134     PALMETTO PHARMACEUTICALS,INC                               01/01/04
68330     CEPHAZONE PHARM,LLC                                                    01/01/08
68820     NORTHSTAR RX LLC                                                             01/01/08
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 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.

ATTENTION MHR PROVIDERS

EFFECTIVE 12-1-2007, THE PRACTICE OF SPAN-DATING, WHICH IS BILLING FOR ALL SERVICES PROVIDED OVER A PERIOD OF TIME RATHER THAN DAILY, WILL BE ELIMINATED. PROVIDERS SHOULD IMMEDIATELY CONTACT THEIR INDIVIDUAL BILLING AGENTS TO DETERMINE THE EFFECT THIS CHANGE MIGHT HAVE ON CURRENT OPERATIONS AND BILLING PROCEDURES.

ATTENTION DENTAL PROVIDERS

CERTAIN CLAIMS FOR DENTAL PROCEDURE CODES D2140 AND D2330 THAT WERE PROCESSED BY MEDICAID BETWEEN THE DATES OF SEPTEMBER 11, 2007 THROUGH OCTOBER 2, 2007 WERE INADVERTENTLY DENIED. AS A RESULT OF THESE CLAIM  DENIALS, CERTAIN CLAIMS FOR DENTAL PROCEDURE CODES D9230 AND D9920 ALSO WERE DENIED. ALL INVOLVED CLAIMS WILL BE AUTOMATICALLY RECYCLED BY MEDICAID AND WILL APPEAR ON THE APPLICABLE REMITTANCE ADVICES IN THE NEAR FUTURE. IF YOU HAVE QUESTIONS, YOU MAY CONTACT THE LSU DENTAL MEDICAID UNIT AT 504-941-8206 OR 1-866-263-6534 (TOLL-FREE).

ATTENTION PHARMACY AND PRESCRIBING PROVIDERS

THE PDL LISTING RECENTLY MAILED TO YOU WITH AN EFFECTIVE DATE OF OCTOBER 1, 2007 HAD ONE DRUG DELETED IN ERROR. TRIAMCINOLONE AQ (NASACORT AQ), SHOULD APPEAR ON PAGE 1 OF THE LISTING UNDER THERAPEUTIC CLASS, ALLERGY-
RHINITIS AGENT, NASAL. THE PDL POSTED ON OUR WEBSITE, WWW.LAMEDICAID.COM IS CORRECT. PLEASE ADD THIS DRUG IN THE APPROPRIATE LOCATION ON THE HARD COPY LISTING YOU RECEIVED, AND WE APOLOGIZE FOR ANY INCONVENIENCE CAUSED
BY THIS ERROR.

HOSPITALS: REVENUE CODE 490 ASSOCIATED LINES

ON THE CHECK WRITE OF SEPTEMBER 25, 2007, ASSOCIATED LINES BILLED WITH REVENUE CODE 490 WERE INADVERTENTLY PAID IN ERROR FOR DATES OF SERVICES BEGINNING AUGUST 1, 2005. THEREFORE, ON THE CHECK WRITE OF NOVEMBER 27, 2007 THIS ERROR HAS BEEN CORRECTED AND ALL PAYMENTS FOR THE ASSOCIATED LINES HAVE BEEN VOID. ADDITIONAL INFORMATION MAY BE OBTAINED BY CONTACTING PROVIDER RELATIONS.

HOSPITAL OUTPATIENT LABORATORY REIMBURSEMENT

EFFECTIVE SEPTEMBER 1, 2006 AN ERROR WAS MADE IN PROGRAMMING LOGIC AND HOSPITALS WERE INADVERTENTLY REIMBURSED FOR LABS AT 100% OF BILLED CHARGES. EFFECTIVE OCTOBER 8, 2007 LOGIC WAS CHANGED TO REFLECT REIMBURSEMENT BASED ON THE FEE SCHEDULE. PAID CLAIMS WERE ADJUSTED ON THE CHECK WRITE OF OCTOBER 16, 2007. FOR ADDITIONAL INFORMATION, CONTACT PROVIDER RELATIONS.