RA Messages for May 15, 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 |
| CODEINE PHOS/APAP |
TAB |
30-300MG |
0.09770 |
04/17/01 |
| CODEINE PHOS/APAP |
TAB |
60-300MG |
0.17800 |
04/17/01 |
**NOTE MAC PRICE CORRECTION FOR ABOVE 2 PRODUCTS. THE NEW FUL WAS
SHOWN,HOWEVER, THE STATE MAC WHICH IS LOWER TAKES PRECEDENCE.**
PLEASE
MAKE THE FOLLOWING CHANGES TO THE 12/9/00 VERSION OF APPENDIX C:
| LABELER |
COMPANY |
BEGIN |
END |
| 00038 |
STUART PHARMACEUTICALS |
|
07/01/01 |
| 00563 |
SANOFI-SYNTHELABO INC |
|
07/01/01 |
| 00591 |
WATSON PHARMA, INC |
07/01/01 |
|
| 43797 |
ROBERTS PHARMACEUTICAL CORP |
|
07/01/01 |
| 49580 |
AARON
INDUSTRIES, INC |
|
07/01/01 |
| 60232 |
SWISS AMERICAN PRODUCTS |
|
07/01/01 |
| 61123 |
NARD LABORATORIES, INC |
|
07/01/01 |
| 61147 |
APOTEX-MAJOR |
|
07/01/01 |
| 64813 |
ALGOS PHARMACEUTICAL CORP |
|
07/01/01 |
| 65628 |
CUTISPHARMA |
|
07/01/01 |
| 65880 |
SIRIUS LABORATORIES, INC |
07/01/01 |
|
PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN
INCORRECTLY PAID.
PHARMACY POS PROVIDERS
POS CLAIM PROCESSING WILL NOT BE AVAILABLE SUNDAY MORNING, MAY 19,2001
(12:01 AM UNTIL 7:00 AM) DUE TO SYSTEM UPGRADE INSTALLATIONS.
CLAIMS PROCESSED WITHIN THIS TIME
PERIOD MAY BE SUBMITTED UPON ACTIVATION OF POS
SYSTEM.
ATTENTION PHARMACY PROVIDERS
THE PHARMACY BENEFITS MANAGEMENT SECTION HAS RESTRUCTURED. WE
ARE PROVIDING YOU WITH UPDATED CONTACT INFORMATION.
M.J. TERREBONNE, PHARMACY DIRECTOR - 225/342-9768
RACHEL BROUSSARD, POLICY AND OPERATIONS - 225/342-9768
MELWYN WENDT, AUDITS AND LOCK-IN - 225/219-4156
GALE NADLER, LOCK-IN - 225/219-4156
TIMOTHY WILLIAMS, REBATE - 225/342-5194
GERALYN STOCKSTILL - 225/342-6046
RECIPIENT FILE CHANGES (CO-PAY EXPEMTION REQUESTS, TRANSPLANT DATES)
FAX NUMBER - 225/342-1980
NOTICE TO PROVIDERS OF PROFESSIONAL SERVICES
EFFECTIVE WITH DATE OF SERVICE JUNE 1, 2001, CPT CODES 82044, 82055, AND
82962 WILL REQUIRE A QW MODIFIER.
NOTICE TO CERTIFIED NURSE PRACTITIONERS
REIMBURSEMENT TO CERTIFIED NURSE PRACTITIONERS WITH A SPECIALTY IN
NEONATOLOGY FOR CPT CODES 32020 (TUBE THORACOSTOMY WITH OR WITHOUT WATER SEAL), 99255 (INITIAL INPATIENT CONSULTATION; NEW OR ESTABLISHED
PATIENT), AND 99360 (PHYSICIAN STANDBY SERVICES) WILL BECOME EFFECTIVE WITH DATE OF SERVICE JUNE 1, 2001. PLEASE NOTE THESE CODES ARE PAYABLE TO ONLY NEONATAL NURSE PRACTITIONERS.
CERTIFIED NURSE PRACTITIONERS WITH A SPECIALTY IN WOMEN'S HEALTH WILL BE
REIMBURSED FOR CPT CODES 76805 (ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED), 76816
(ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; FOLLOW-UP OR REPEAT), 76818 (FETAL BIOPHYSICAL PROFILE; WITH NON-STRESS
TEST), 76830 (ECHOGRAPHY, TRANSVAGINAL), 76856 (ECHOGRAPHY, PELVIC, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTAION; COMPLETE), AND 59025 (FETAL NON-STRESS TEST) EFFECTIVE THE SAME DATE. CNPS WITH SPECIALTIES
IN OTHER AREAS SHOULD NOT BILL THESE CODES.