RA Messages for February 25, 2003

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 1/01/02 VERSION OF APPENDIX C:

LABELER COMPANY  BEGIN END
11523 SCHERING PLOUGH HEALTHCARE PRODUCTS INC 04/01/03   

PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID

HIPAA NOTICE

LA MEDICAID IS USING A HIPAA TESTING SERVICE FOR NON-POS ELECTRONIC SUBMITTERS WHO WOULD LIKE TO BE APPROVED TO SEND HIPAA COMPLIANT CLAIMS TO LA MEDICAID FOR PAYMENT. ASK YOUR SOFTWARE VENDOR, BILLING AGENT, CLEARINGHOUSE, OR SUBMITTER TO EMAIL *HIPAAEDI@UNISYS.COM OR CALL 1-225-237-3318 TO GET ENROLLED IN OUR HIPAA TESTING SERVICE. PHARMACY POS SUBMITTERS MUST CERTIFY WITH THEIR SWITCH VENDOR FOR NCPDP 5.1. NO TESTING IS REQUIRED WITH UNISYS. 

ATTENTION ALL PROVIDERS

THE PROVIDER ENROLLMENT UNIT HAS A NEW PHONE NUMBER. IT IS 225-237-3370. 

CORRECTED NOTICE TO HOSPITAL PROVIDERS

WE WANT TO REMIND YOU THAT UNISYS OFFICES ARE NOT CLOSED FOR MARDI GRAS; THEREFORE, HOSPITAL PRECERTIFICATION REQUESTS SHOULD BE SUBMITTED FOLLOWING REGULAR BUSINESS GUIDELINES. UNISYS 2003 HOLIDAYS FOLLOW: 
GOOD FRIDAY(04/18/03);MEMORIAL DAY(05/26/03);INDEPENDENCE DAY(07/04/03); LABOR DAY (09/02/03); THANKSGIVING DAY AND THE FOLLOWING FRIDAY(11/27&28/03);AND CHRISTMAS DAY AND THE FOLLOWING FRIDAY (12/25&26/03). 

NOTICE TO HOSPICE PROVIDERS

A MINOR CHANGE IS BEING MADE IN THE BILLING INSTRUCTIONS FOR UB-92 BILLING AS FOLLOWS; FIELDS 39-41. VALUE CODES-ENTER VALUE CODE 61 IN THE "CODE" SECTION OF THE FIELD; THE MSA CODE/RURAL STATE CODE IN THE DOLLAR PORTION OF THE "AMOUNT" SECTION OF THE FIELD; AND ENTER DOUBLE ZEROS (00) IN THE "CENTS" SECTION OF THE FIELD. PLEASE MAKE THIS CHANGE TO YOUR BILLING PROCEDURES. CORRECTED BILLING INSTRUCTIONS WILL BE MAILED TO YOU SHORTLY. IF YOU HAVE QUESTIONS CONCERNING THIS CHANGE, PLEASE CONTACT UNISYS PROVIDER RELATIONS AT 800-473-2783. 

ATTENTION NURSING HOME & HOSPICE PROVIDERS

EFFECTIVE WITH DATE OF SERVICE JANUARY 1, 2003, RECIPIENT LEVELS OF CARE (LOC)20, 21, AND 22 CHANGED TO LOC 88. THE INITIAL CHANGE FOR PATIENTS ALREADY ON TADS WAS MADE AUTOMATICALLY BY UNISYS ON THE JANUARY 2003 PRE-PRINTED TADS. PROVIDERS BILLING FOR ADD-ONS FOR SERVICE DATES JANUARY 2003 AND AFTER FOR RECIPIENTS WHO WERE LOC 20, 21, AND 22 SHOULD CHANGE THEM TO 88. REMEMBER FOR DATES OF SERVICE PRIOR TO JANUARY 2003, THESE LOCS REMAIN THE SAME.

NOTICE TO PROVIDERS OF PROFESSIONAL SERVICES

CURRENTLY, CPT CODE 99239 IS PAYABLE FOR MEDICARE/MEDICAID RECIPIENTS ONLY.  EFFECTIVE WITH THE DATE OF SERVICE 01/01/2003, THIS CODE WAS MADE PAYABLE FOR STRAIGHT MEDICAID RECIPIENTS ALSO AT A FEE OF $66.42.

NOTICE TO PROVIDERS OF PROFESSIONAL SERVICES

EFFECTIVE WITH THE DATE OF SERVICE JANUARY 1, 2003, HCPCS CODE G0181 FOR HOME HEALTH CARE SUPERVISION WAS MADE PAYABLE AT A FEE OF $107.10.  THIS CODE IS RESTRICTED TO CROSS-OVER CLAIMS.