RA Messages for November 9, 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
|
| GLIPIZIDE |
TAB SA OSM
|
2.5MG
|
|
10/04/99 |
| QUINUPRISTINL DALFOPRISTIN |
VIAL
|
500MG |
|
09/22/99 |
| SIROLIMUS |
SOLUTION |
1MG/ML |
|
09/20/99 |
PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN
INCORRECTLY PAID.
NOTICE TO PHARMACISTS AND PHYSICIANS
EFFECTIVE FOR SERVICES BEGINNING OCTOBER 26, 1999, THE
BUREAU OF HEALTH SERVICES FINANCING WILL BEGIN REIMBURSING FOR THE FOLLOWING
ANTIHISTAMINE/DECONGESTANT PRODUCTS FOR THE MEDICALLY APPROVED INDICATION OF ALLERGIC
RHINITIS (SEASONAL OR PERENNIAL). PLEASE BE REMINDED THAT IN ACCORDANCE
WITH SECTION 1927 (D)(2) OF THE SOCIAL SECURITY ACT, THE MEDICAID
AGENCY IS ALLOWED TO EXCLUDE COVERAGE OF DRUGS OR CLASSES OF DRUGS
CONTAINING COUGH AND COLD AGENTS WHEN THOSE PRODUCTS ARE PRESCRIBED FOR THE
TREATMENT OF COUGH AND COLDS. IN ADDITION, THE DEPARTMENT WILL COMMENCE DRUG
UTILIZATION REVIEWS ON A RETROSPECTIVE BASIS AS WELL AS DEVELOP PROSPECTIVE DRUG
UTILIZATION CRITERIA TO REDUCE THERAPEUTIC DUPLICATION OF ANTIHISTAMINE PRODUCTS
AND/OR CONCURRENT THERAPY WITH OTHER
ANTIHISTAMINE/DECONGESTANT PRODUCTS.
GENERIC DESCRIPTION
ACRIVASTINE AND PSEUDOEPHEDRINE
AZATADINE AND PSEUDOEPHEDRINE
BROMPHENIRAMINE AND PHENYLEPHRINE
BROMPHENIRAMINE,PHENYLEPHRINE AND PHENYLPROPANOLAMINE
BROMPHENIRAMINE AND PSEUDOEPHEDRINE
CARBINOXAMINE AND PSEUDOEPHEDRINE
CHLORPHENIRAMINE,PHENINDAMINE AND PHENYLPROPANOLAMINE
CHLORPHENIRAMINE AND PHENYLEPHRINE
CHLORPHENIRAMINE, PHENYLEPHRINE AND PHENYLPROPANOLAMINE
CHLORPHENIRAMINE AND PHENYLPROPANOLAMINE
CHLORPHENIRAMINE,PHENYLTOLOXAMINE AND PHENYLEPHRINE
CHLORPHENIRAMINE,PHENYLTOLOXAMINE,PHENYLEPHRINE AND
PHENYLPROPANOLAMINE
CHLORPHENIRAMINE AND PSEUDOEPHEDRINE
CHLORPHENIRAMINE,PYRILAMINE,PHENYLEPHRINE AND
PHENYLPROPANOLAMINE
CLEMASTINE AND PHENYLPROPANOLAMINE
DEXBROMPHENIRAMINE AND PSEUDOEPHEDRINE
DIPHENHYDRAMINE AND PSEUDOEPHEDRINE
FEXOFENADINE AND PSEUDOEPHEDRINE
LORATADINE AND PSEUDOEPHEDRINE
PHENIRAMINE AND PHENYLEPHRINE
PHENIRAMINE,PHENYLTOLXAMINE,PYRILAMINE AND
PHENYLPROPANOLAMINE
PHENIRAMINE, PYRILAMINE AND PHENYLPROPANOLAMINE
PROMETHAZINE AND PHENYLEPHRINE
TRIPROLIDINE AND PSEUDOEPHEDRINE
CHLORPHENIRAMINE,PHENYLEPHRINE AND METHSCOPOLAMINE
CHLORPHENIRAMINE,PHENYLEPHRINE,PHENYLPROPANOLAMINE,ATROP,HYOSCY,SCOPOLAM
CHLORPHENIRAMINE,PHENYLPROPANOLAMINE AND METHSCOPOLAMINE
CHLORPHENIRAMINE,PSEUDOEPHEDRINE AND METHSCOPOLAMINE
THE UNISYS EMC DEPARTMENT IS UNDERGOING TESTING TO ENSURE
THAT EMC SUBMISSIONS ARE Y2K READY. EMC VENDORS AND SUBMITTERS WILL NOT
CHANGE THE PROCESS CURRENTLY BEING USED TO SUBMIT EMC CLAIMS TO UNISYS.
ALL REQUIRED CHANGES ARE BEING MADE BY UNISYS WITHIN MMIS TO CONVERT NECESSARY
DATA TO Y2K STATUS. IF YOU RELY ON ANOTHER ENTITY (I.E., BILLING SERVICE,
CLEARINGHOUSE) TO BILL CLAIMS OR RECONCILE ACCOUNTS ON YOUR BEHALF, PLEASE SHARE
THIS INFORMATION WITH THEM. IF ENTITIES ARE NOT INFORMED AND/OR NOT Y2K
READY, IT MAY CAUSE DIFFICULTY FOR YOU.
NOTICE TO NURSE PRACTITIONERS
CPT CODE 99282 HAS BEEN ADDED TO THE LIST OF PAYABLE TO
CERTIFIED NURSE PRACTITIONERS WITH AN EFFECTIVE DATE OF AUGUST 1, 1999.
NOTICE TO PROFESSIONAL PROVIDERS
CODES DISCONTINUED IN THE 1999 ISSUANCE OF THE CURRENT
PROCEDURAL TERMINOLOGY WILL BE PLACED IN NON-PAY STATUS EFFECTIVE DATE OF
SERVICE DECEMBER 1, 1999.
NOTICE TO PHYSICIANS AND KIDMED PROVIDERS
RE: ROTOVIRUS VACCINE (PROCEDURE CODE 90680) WYETH LEDERLE
VACCINES ANNOUNCED THAT IT HAS WITHDRAWN ITS ROTASHEILD VACCINE FROM THE MARKET
AND HAS REQUESTED THE IMMEDIATE RETURN OF ALL DOSES OF THE VACCINE.
THEREFORE, PROCEDURE CODE 90680 (ROTOVIRUS) IS NO LONGER PAYABLE BY
LOUISIANA MEDICAID EFFECTIVE 10/19/1999.