RA Messages for May 13, 2003

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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 1-800488-6334 OR 225-928-5263. WHEN SUBMITTING REQUESTS FOR AUTHORIZATION OF SERVICES, EQUIPMENT, OR SUPPLIES FOR A MEMBER OF THE CHISHOLM CLASS, 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.

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HIPAA NOTICE TO ALL PROVIDERS

IN AN EFFORT TO KEEP OUR PROVIDERS UP-TO-DATE WITH NEWLY DEVELOPED LA MEDICAID HIPAA REFERENCE MATERIALS, THE LA MEDICAID'S WEBSITE IS BEING UPDATED REGULARLY TO INCLUDE THE FOLLOWING HIPAA REFERENCE MATERIALS: PROVIDER TRAINING SCHEDULES; PROVIDER TRAINING MATERIALS; VENDOR/BILLING AGENCY/CLEARINGHOUSE (VBC) LIST; TESTING SERVICE ENROLLMENT FORM; AND LTC SURVEY.

PLEASE VISIT OUR WEBSITE AT WWW.LAMEDICAID.COM AND CLICK ON THE "HIPAA INFORMATION CENTER" ICON TO OBTAIN THE MOST CURRENT HIPAA REFERENCE MATERIALS.

FOR THOSE PROVIDERS WHO MAY NOT HAVE ACCESS TO THE WEBSITE, YOU MAY CALL UNISYS PROVIDER RELATIONS AT 800-473-2783.

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HIPAA ALERT

HIPAA IMPLEMENTATION IS LESS THAN 6 MONTHS AWAY!

IF YOU PLAN TO SUBMIT CLAIMS ELECTRONICALLY, YOU MUST REQUIRE YOUR SOFTWARE VENDOR, BILLING AGENT, OR CLEARINGHOUSE (VBC) TO ENROLL IN UNISYS' TESTING PROGRAM. VBC REQUEST ENROLLMENT BY SENDING AN EMAIL TO *HIPAAEDI@UNISYS.COM (NOTE: * IS PART OF THE EMAIL ADDRESS) OR BY CALLING 225-237-3318.

UNISYS PRODUCES A WEEKLY STATUS LIST OF ALL SOFTWARE VENDORS, BILLING AGENTS, AND CLEARINGHOUSES (VBC) THAT ARE PURSUING HIPAA READINESS WITH LA MEDICAID.  TO SUBSCRIBE TO THE VBC LIST, PLEASE SEND AN EMAIL TO *HIPAAEDI@UNISYS.COM (NOTE: * IS PART OF THE EMAIL ADDRESS) AND PUT "SUBSCRIBE TO VBC LIST" IN THE SUBJECT LINE.

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NOTICE TO PROVIDERS OF PROFESSIONAL SERVICES

EFFECTIVE WITH DATE OF SERVICE MAY 1, 2003, THE FOLLOWING CPT CODES WILL
BE ADDED TO THE LIST OF CODES PAYABLE TO ASSISTANT SURGEONS: 

58551 LAPAROSCOPY, REMOVE MYOMA 
58660 LAPAROSCOPY, LYSIS 
58661 LAPAROSCOPY, REMOVE ADNEXA 
58662 LAPAROSCOPY, EXCISE LESIONS 
58673 LAPAROSCOPY, SALPINGOSTOMY 

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NOTICE TO CNPS AND CNSS

EFFECTIVE WITH DATE OF SERVICE MAY 1, 2003, THE FOLLOWING CPT CODES WILL
BE ADDED TO THE LIST OF CODES PAYABLE TO CNPS AND CNSS:

 96115 99232 99244 99252 99261 
99221 99233 99245 99253 99262 
99223 99243 99251 99254 99263 

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NOTICE TO PROVIDERS OF PROFESSIONAL SERVICES

A CLAIM TYPE RESTRICTION WAS PLACED IN ERROR ON PROCEDURE CODE Q0111 IN 
MARCH 2003. THIS ERROR HAS BEEN CORRECTED. DENIED CLAIMS FOR THIS CODE 
MAY BE REBILLED. WE APOLOGIZE FOR THE INCONVENIENCE CAUSED BY THIS 
OVERSIGHT. 

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ATTENTION ALL PROVIDERS OF DURABLE MEDICAL EQUIPMENT (DME)

EFFECTIVE MAY 1, 2003, REIMBURSEMENT FOR A NEBULIZER WITH COMPRESSOR HAS
BEEN REDUCED FROM A MAXIMUM OF $95.00 TO A MAXIMUM OF $60.00, NOT TO 
EXCEED THE PROVIDER'S USUAL AND CUSTOMARY CHARGES. THIS REDUCTION WAS 
PUBLISHED AS A RULE IN THE APRIL 20, 2003 EDITION OF THE LOUISIANA 
REGISTER.

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NOTICE TO PHYSICIANS, ANESTHESIOLOGISTS, AND HOSPITALS

SUBMISSIONS FOR CHARGES RELATED TO STERILIZATION PERFORMED WHEN THE CONSENT WAS NOT OBTAINED THIRTY DAYS PRIOR TO THE STERILIZATION MUST INCLUDE DOCUMENTATION TO CONFIRM THE EXPECTED DATE OF DELIVERY (EDD) IN ADDITION TO THE CONSENT FORM WITH THE EDD INDICATED IN THE PROPER AREA ON THE FORM. THIS ADDITIONAL DOCUMENTATION MUST CONTAIN THE EDD AND MAY BE A COMPUTER GENERATED ULTRASOUND REPORT OR OFFICE RECORDS TO CONFIRM EDD.  IT IS NOT NECESSARY TO SEND THE ENTIRE MEDICAL RECORD.

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NOTICE TO ALL DENTAL PROVIDERS BILLING HARDCOPY

DHH HAS DECIDED TO TEMPORARILY SUSPEND THE MANDATORY REQUIREMENT OF THE 2002 AMERICAN DENTAL ASSOCIATION (ADA) CLAIM FORM UNTIL FURTHER NOTICE.