RA Messages for December 26, 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 CHANGE TO APPENDIX A:
            DRUG                                             DOSAGE             STRGTH                     MAC                     EFF.DATE
         ERGOCALCIFEROL                        CAPSULE            50000 U                 OFF MAC                   12/13/07
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 ALL PROVIDERS

EFFECTIVE WITH DATES OF SERVICE OCTOBER 1, 2007 FORWARD, THE 2008 ICD-9 DISEASE AND PROCEDURE CLASSIFICATION CODE UPDATES HAVE BEEN ADDED TO OUR FILES. CLAIMS THAT HAVE DENIED FOR INVALID DIAGNOSIS/PROCEDURE CODES PRIOR TO THE LOADING OF THE 2008 ICD-9 DATA WILL BE RECYCLED AND NO ACTION IS REQUIRED BY THE PROVIDER. PROVIDERS WILL BE INFORMED VIA RA MESSAGE WHEN THE RECYCLE WILL TAKE PLACE.

ATTENTION PHYSICIANS

THE FOLLOWING CPT CODE WILL BE ADDED TO THE LIST OF CODES THAT REQUIRE A QW MODIFIER, EFFECTIVE 09/18/2006:

87807 - QW - RSV ASSAY W/OPTIC

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 ALL PROFESSIONAL SERVICE PROVIDERS

EFFECTIVE WITH DATES OF SERVICE SEPTEMBER 10, 2007 FORWARD, LOUISIANA MEDICAID IS INCREASING TO $468.71 THE REIMBURSEMENT RATE PAID FOR MIRENA (LEVONORGESTREL RELEASING INTRAUTERINE SYSTEM 20 MCG/ DAY) NDC 50419-0421-01, J7302, TO PROFESSIONAL SERVICE PROVIDERS. BE REMINDED THAT THE FEDERAL STATUTE REQUIRING THE USE OF THE NATIONAL DRUG CODE (NDC) ON CLAIMS FOR PHYSICIAN ADMINISTERED DRUGS WILL SOON BE IMPLEMENTED IN THE LOUISIANA MEDICAID CLAIMS PROCESSING SYSTEM.

ATTENTION OPTOMETRISTS

PROCEDURE CODE 92225 IS BEING MADE PAYABLE RETROACTIVE TO JANUARY 1, 2006. ALL OPTOMETRY CLAIMS FOR PROCEDURE CODE 92225 WITH DATES OF SERVICE JANUARY 1, 2006 FORWARD WHICH DENIED DUE TO NON-COVERAGE WILL BE RECYCLED AND WILL APPEAR ON THE REMITTANCE ADVICE FOR DECEMBER 11, 2007.