RA Messages for February 10, 2004

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.

DRUG DOSAGE STRGTH MAC EFF DATE
OXYCODONE/ASPRIN TABLET 4.88 - 325 MG 0.75920 01/01/04
TESTOSTERONE CYPIONATE VIAL 100MG/ML OFF MAC 01/01/04

PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID.

                     HOME AND COMMUNITY-BASED WAIVER SERVICES

FOR INFORMATION ABOUT HOME AND COMMUNITY-BASED WAIVER SERVICES AS AN 
ALTERNATIVE LONG TERM CARE OPTION, PLEASE CALL 1-800-660-0488.

NOTICE TO PROVIDERS OF PROFESSIONAL SERVICES

THE LAST PARAGRAPH OF THE ARTICLE ENTITLED CHANGES TO PAYABLE INJECTIONS POLICY ON PAGE 51 OF THE 2003 PROFESSIONAL SERVICES TRAINING PACKET CONTAINS AN ERROR WHICH WE REQUEST PROVIDERS CORRECT. THE CODE FOR THE IMPLEMENTATION OF THE INTRAUTERINE COPPER CONTRACEPTIVE SHOULD BE 58300 INSTEAD OF CODE 58310. PLEASE REBILL DENIED CLAIMS FOR IMPLEMENTATION WITH CODE 58300.

NOTICE TO ALL PROVIDERS

CP-O-92 AND RS-O-07 REPORTS ARE NOW AVAILABLE ON-LINE AT LAMEDICAID.COM.  HARD COPIES AND DISKETTES OF THESE REPORTS WILL NO LONGER BE MAILED AFTER THE MARCH 1, 2004 REPORTS.

IF YOU DO NOT HAVE WEB ACCESS, PLEASE CALL PROVIDER RELATIONS AT 800/473-2783 OR 225/924-5040 BY FEBRUARY 13, 2004 TO REQUEST CONTINUED MAILINGS OF THESE REPORTS. IF YOU DO NOT CALL BY FEBRUARY 13, THESE REPORTS WILL NO LONGER BE MAILED TO YOU.

NOTICE TO PODIATRISTS

EFFECTIVE WITH DATE OF SERVICE NOVEMBER 1, 2003, THE FOLLOWING CPT CODES
WERE ADDED TO THE LIST OF CODES PAYABLE TO PODIATRISTS: 
                                                            15342                 20694 

NOTICE TO DENTAL PROVIDERS

MEDICAID RECENTLY IDENTIFIED A PROBLEM THAT CAUSED THE ERRONEOUS DENIAL (EOB 917-LIFETIME LIMITS FOR THIS SERVICE HAVE BEEN EXCEEDED) OF SOME CLAIMS FOR PROCEDURE CODE D3310 (ANTERIOR ROOT CANAL) THAT WERE PROCESSED FROM MAY 1, 2003 THROUGH JANUARY 16, 2004 AND INCLUDED DATES OF SERVICE MAY 1, 2003 AND AFTER. THIS PROBLEM HAS BEEN CORRECTED AND ALL CLAIMS FOR PROCEDURE CODE D3310 THAT DENIED WITH ERROR CODE 917 WITHIN THE TIME PERIOD MENTIONED ABOVE WERE AUTOMATICALLY RECYCLED BY MEDICAID AND APPEARED ON THE REMITTANCE ADVICE DATED JANUARY 27, 2004. PLEASE KEEP IN MIND THAT NOT ALL CLAIMS THAT WERE RECYCLED WILL PAY. SOME MAY DENY FOR VALID REASONS SUCH AS DUPLICATE CLAIM, LACK OF PRIOR AUTHORIZATION, ETC. SHOULD YOU HAVE ANY QUESTIONS, YOU MAY CONTACT THE DENTAL MEDICAID UNIT BY CALLING 504-619-8589.