RA Messages for March 26, 2002

 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 1/1/02 VERSION OF APPNEDIX A: 

DRUG DOSAGE  STRGTH MAC  EFF DATE
METHYLPREDNISOLONE ACE VIAL 80MG/ML OFF MAC 03/01/02 
NORETHINDRONE-ETHINYL EST TABLET 1-0.35MG 28'S OFF MAC 03/01/02 
PROCAINAMIDE HCL TABLET SA 750MG OFF MAC 03/01/02 

PLEASE MAKE THE FOLLOWING CHANGES TO THE 1/1/02 VERSION OF APPENDIX C:

LABELER               COMPANY BEGIN END
08367 RX HOLDINGS, LLC (DBA RXELITE) 07/01/02   
66794 RX HOLDINGS, LLC (DBA RXELITE) 07/01/02    
66870 AMBI PHARMACEUTICALS, INC.  07/01/02    

 PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID

NOTICE TO KIDMED PROVIDERS

EFFECTIVE IMMEDIATELY, THE KIDMED OBJECTIVE HEARING AND VISION SCREENINGS (CODES 92551 AND X9007) MAY BE PERFORMED BY TRAINED OFFICE STAFF UNDER THE SUPERVISION OF A LICENSED MEDICAID PHYSICIAN, PHYSICIAN ASSISTANT, OR REGISTERED NURSE OR AN OPTOMETRIST FOR VISION SCREENING AND LICENSED AUDIOLOGIST OR SPEECH PATHOLOGIST FOR HEARING SCREENINGS. PLEASE MAKE THESE CHANGES TO YOUR KIDMED POLICY MANUAL. THE INTERPRETIVE CONFERENCE TO DISCUSS ANY FINDINGS FROM THE SCREENINGS MUST STILL BE PERFORMED BY A LICENSED PHYSICIAN, PHYSICIAN ASSISTANT, OR REGISTERED NURSE AS IS CURRENTLY THE POLICY AND STATED IN THE KIDMED MANUAL. 

NOTICE TO PERSONAL CARE SERVICES (PCS) PROVIDERS

PROVIDERS CAN NOW CONTACT LYNDA WASCOM AT (225)342-9485 FOR ISSUES CONCERNING PERSONAL CARE SERVICES. PLEASE CALL HER WITH YOUR QUESTIONS REGARDING POLICY, PRIOR AUTHORIZATION, AND PARTICIPATION IN THE PROGRAM.

REMINDER REGARDING COMMUNITYCARE RECIPIENTS

EFFECTIVE JULY 1, 2000, THE FOLLOWING CODES USED TO BILL FOR PHYSICIAN SERVICES RENDERED IN HOSPITAL EMERGENCY ROOMS, CPT CODES 99281, 99282, 99283, 99284, AND 99285, ARE NOT COUNTED IN THE TWELVE VISIT LIMIT FOR PHYSICIAN VISITS FOR ADULT RECIPIENTS - THIS IS APPLICABLE ONLY TO COMMUNITYCARE-ENROLLED RECIPIENTS. IN ADDITION, THE LIMIT OF THREE VISITS PER YEAR FOR REVENUE CODES HR450 AND HR459 IS NOT APPLICABLE TO COMMUNITYCARE RECIPIENTS. PROVIDERS SHOULD BE AWARE THAT THE ELIGIBILITY VERIFICATION SYSTEMS (REVS AND MEVS) MAY REFLECT A NUMBER OF ER VISITS REMAINING FOR A COMMUNITYCARE RECIPIENT, BUT THAT THERE IS NO LIMIT FOR HR450 AND HR 459 FOR COMMUNITYCARE ENROLLEES.  

QUESTIONS REGARDING THIS CHANGE MAY BE DIRECTED TO UNISYS PROVIDER RELATIONS AT 800 473-2783.