RA Messages for April 29, 2003

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ALL PROVIDERS

AN ERROR WAS IDENTIFIED WITHIN THE WEEKLY CLAIMS CYCLE ON MARCH 14, 2003.  THIS ERROR OCCURRED DUE TO HIPAA CHANGES.  THIS ERROR CAUSED WITHIN THE WEEKLY CLAIMS TO BE INCORRECTLY SORTED IMPACTING DUPE CHECK PROCESSING.  THE CLAIMS RECYCLES ON 3/18, 3/25, AND 4/1.  PLEASE RECONCILE YOUR RAS AND NOTIFY PROVIDER RELATIONS IF YOUR CLAIMS STILL PAID INCORRECTLY.

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ALL PROVIDERS OF REHABILITATION SERVICES

ON MARCH 4, MEDICAID BEGAN PAYING THE INCREASES RATES FOR THERAPY SERVICES PROVIDED TO RECIPIENTS UNDER THE AGE OF 3 AS PUBLISHED IN THE JULY 2002 LOUISIANA REGISTER.  THESE INCREASED RATES ARE EFFECTIVE FOR DATES OF SERVICE BEGINNING ON JULY 6, 2002.  DHH WILL PERFORM A RECYCLE OF CLAIMS ORIGINALLY ADJUDICATED AT THE OLD RATE TO PAY PROVIDERS THE NEW INCREASED RATE.  PLEASE REFER TO THE JULY 2002 LOUISIANA REGISTER FOR A LIST OF THE NEW RATES.

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NOTICE TO PROVIDERS OF PROFESSIONAL SERVICES

EFFECTIVE WITH THE DATE OF SERVICE FEBRUARY 1, 2003, CPT CODE J9219 (LEUPROLIDE ACETATE IMPLANT 65 MG) WAS MADE PAYABLE AT A FEE OF $4,252.91. THE IMPLANT INSERTION (CPT CODE FEE FOR 11981) IS $107.06 AND THE FEE FOR THE REMOVAL OF THE IMPLANT (CPT CODE 11982) IS $122.51.

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ATTENTION ALL HEMODIALYSIS PROVIDERS

EFFECTIVE WITH CLAIM DATES OF SERVICE MAY 1, 2003, TWO ADDITIONAL HIPAA STANDARD CODES CHANGES ARE BEING MADE THAT WERE NOT CORRECTLY  INDICATED IN THE TRAINING PACKETS DISTRIBUTED AT THE RECENT 2003 PROVIDER TRAINING WORKSHOPS. PROCEDURE CODE Z6138 (CALCITROL, 2MCG) SHOULD BE CROSSWALKED TO CODE J0636 (CALCITROL.1MCG). LOCAL PROCEDURE CODE J0960 (DELATESTRYL INJECTION) SHOULD BE CROSSWALKED TO CODE J3120 (TESTOSTERONE ENANTHATE INJECTION - UP TO 100 MG).

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ATTENTION ALL PROVIDERS OF AUTHORIZED SERVICES

PLEASE DO NOT SUBMIT A REQUEST TO THE PRIOR AUTHORIZATION UNIT MORE THAN ONCE. IDENTICAL SUBMISSION OF THE SAME PRIOR AUTHORIZATION REQUEST CAUSE ERRORS AND IMPEDE THE PROCESS.  INQUIRIES REGARDING PENDING REQUESTS SHOULD BE DIRECTED TO THE PRIOR AUTHORIZATION UNIT AT 1-800-488-6334 OR 225-928-5263. WHEN SUBMITTING REQUESTS FOR AUTHORIZATION OF SERVICES, EQUIPMENT, OR SUPPLIES FOR A MEMBER OF THE CHISHOLM CASE, PLEASE INCLUDE THE NAME, ADDRESS, AND TELEPHONE NUMBER OF THE RECIPIENT'S CASE MANAGER ON THE FORM PA01 IN THE COMMENTS SECTION. QUESTIONS RELATED TO THIS MATTER SHOULD BE DIRECTED TO THE BUREAU OF COMMUNITY SERVICES (BCSS) AT 1-800-660-0488.

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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.