RA Messages for February 27, 2001
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
PROFESSIONAL SERVICE PROVIDERS
EFFECTIVE WITH DATE OF SERVICE MARCH 1, 2001, LOUISIANA MEDICAID'S POLICY ON REIMBURSEMENT FOR OBSTETRIC SONOGRAMS WILL BECOME THE FOLLOWING:
ONE COMPLETE SONOGRAM (EITHER CODE 76805 OR CODE 76810) AND TWO FOLLOW UP SONOGRAMS (EITHER TWO 76815S, TWO 76818S OR A COMBINATION OF 76815 AND 76816) WILL BE REIMBURSED PER RECIPIENT PER 270 DAYS PER PROVIDER.
THIRD AND SUCCEEDING CLAIMS FOR 76815 OR 76816 WITH A DIAGNOSIS CODE OF V22, V22.0, V22.1, OR V22.2 FROM ANY PROVIDER WILL BE DENIED.
THIRD AND SUCCEEDING CLAIMS FOR 76815 OR 76816 WITH A DIAGNOSIS CODE OTHER THAN THOSE ABOVE WILL BE DENIED UNLESS ACCOMPANIED BY DATED NOTES WHICH JUSTIFY MEDICAL NECESSITY, AS THESE CLAIMS WILL PEND FOR REVIEW.
ATTENTION ALL MEDICAID PROVIDERS
THE CURRENT ENROLLMENT FUNCTIONS CURRENTLY PERFORMED BY THE LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS PROVIDER ENROLLMENT UNIT WILL BE TRANSFERRED TO UNISYS CORPORATION EFFECTIVE MARCH 1, 2001. THEY MAY BE CONTACTED AT THE FOLLOWING ADDRESS: UNISYS - PROVIDER ENROLLMENT UNIT, P.O. BOX 80159, BATON ROUGE, LA 70898-0159. IF YOU HAVE A PENDING ENROLLMENT APPLICATION, YOU DO NOT NEED TO CONTACT THE UNISYS PROVIDER ENROLLMENT UNIT. ALL PENDING APPLICATIONS WILL BE TRANSFERRED AND PROCESSED AS QUICKLY AS POSSIBLE.