RA Messages for April 24, 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.
PLEASE MAKE THE FOLLOWING CHANGES TO THE
12/9/00 VERSION OF APPENDIX A
|
DRUG |
DOSAGE |
STRGTH |
MAC |
EFF.DATE |
| CARBIDOPA/LEVODOPA |
TAB |
10-100MG |
0.36450 |
04/17/01 |
| CARBIDOPA/LEVODOPA |
TAB |
25-100MG |
0.39150 |
04/17/01 |
| CARBIDOPA/LEVODOPA |
TAB |
25-250MG |
0.46570 |
04/17/01 |
| CEPHALEXIN MONOHYDRATE |
SUSP RECON |
125MG/5ML |
0.06312 |
04/17/01 |
| CEPHALEXIN MONOHYDRATE |
SUSP RECON |
250MG/5ML100S |
0.12250 |
04/17/01 |
| CEPHALEXIN MONOHYDRATE |
SUSP RECON |
250MG/5ML
200S |
0.11600 |
04/17/01 |
| CODEINE PHOS/APAP |
TAB |
30-300MG |
0.14650 |
04/17/01 |
| CODEINE PHOS/APAP |
TAB |
60-300MG |
0.23640 |
04/17/01 |
| HALOPERIDOL |
TAB |
10MG |
0.65000 |
04/17/01 |
| ISONIAZID |
TAB |
300MG |
0.06720 |
04/17/01 |
| METOCLOPRAMIDE HCL |
TAB |
10MG |
0.04350 |
04/17/01 |
| NEOMY SULF/GRAMICID |
D/POLY DROPS |
1.85250 |
|
04/17/01 |
| NYSTATIN |
TAB |
500MU |
0.47170 |
04/17/01 |
| PENICILLIN V POTASSIUM |
TAB |
250MG |
0.07200 |
04/17/01 |
| PROCAINAMIDE HCL |
TAB SA |
500MG |
0.26920 |
04/17/01 |
| TRIMETHOPRIM |
TAB |
100MG |
0.23350 |
04/17/01 |
PLEASE
MAKE THE FOLLOWING CHANGES TO THE 12/9/00 VERSION OF APPENDIX C:
| LABELER |
COMPANY |
BEGIN |
END |
| 61607 |
INKINE PHARMACEUTICALS |
07/01/01 |
|
| 65293 |
THE MEDICINES COMPANY |
07/01/01 |
|
| 65430 |
DEX GEN PHARMACEUTICALS, INC |
07/01/01 |
|
PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN
INCORRECTLY PAID
.
NOTICE TO HOSPITALS
PLEASE NOTE: THE PROBLEM WITH REVENUE CODE 490 (AMBULATORY SURGICAL CARE)
CLAIMS DENYING IN ERROR WITH ERROR EDIT 266 (REVENUE CODE INVALID FOR AMBULATORY
SURGICAL PROCEDURE) OE EDIT 267 (REVENUE CODE 490 REQUIRES VALID ICD 9 SURGICAL
PROCEDURE) HAS BEEN CORRECTED.
CLAIMS THAT DENIED IN ERROR HAVE BEEN RECYCLED ON YOUR REMITTANCE ADVICE DATED
APRIL 1, 2001. IF YOU HAVE BEEN HOLDING NEW CLAIMS FOR REVENUE CODE 490
BECAUSE OF THIS PROBLEM, YOU MAY SUBMIT THEM NOW. WE APOLOGIZE FOR THE
INCONVENIENCE THIS HAS CAUSED. IF QUESTIONS ARISE, YOU MAY CALL PROVIDER
RELATIONS AT (800)473-2783 OR (225)924-5040.
NOTICE TO PROVIDERS OF PROFESSIONAL SERVICES
EFFECTIVE WITH DATE OF SERVICE APRIL 1, 2001,LOCALLY ASSIGNED
CODE Z9921 (LUNELL MONTHLY CONTRACEPTIVE INJECTION) WAS MADE PAYABLE AT A FEE OF
$21.10.
NOTICE TO DME PROVIDERS
EFFECTIVE WITH DATES OF SERVICE APRIL 6, 2001 AND AFTER, THE
BUREAU HAS INCREASED THE REIMBURSEMENT FOR OSTOMY SUPPLIES (HCPCS A4360-A4421,
A5051-A5149, K0137-K0139, K0278-K0280 AND K0421-K0437) TO 80% OF THE MEDICARE
FEE SCHEDULE, 80% OF THE MSRP OR BILLED CHARGES, WHICHEVER IS LESS.