RA Messages for May 27, 2003

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PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID.

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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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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 ALL DENTAL PROVIDERS

DHH HAS DECIDED TO TEMPORARILY SUSPEND THE MANDATORY REQUIREMENT OF THE 2002 ADA CLAIM FORM USAGE UNTIL FURTHER NOTICE.  WE STRONGLY ENCOURAGE PROVIDERS TO TRANSITION TO THE NEW 2002 FORM AT THIS TIME IF THERE IS NO REASON TO PROHIBIT THIS TRANSITION. DURING THIS INTERIM PERIOD, PROVIDERS WHO ARE HAVING DIFFICULTIES WITH THIS TRANSITION AND CHOOSE TO CONTINUE TO SUBMIT CLAIMS USING PRIOR ACCEPTABLE VERSIONS OF THE ADA CLAIM FORM MUST USE THE TOOTH NUMBER FIELD TO ENTER THE NEW ORAL CAVITY DESIGNATOR WHEN AN OCD IS REQUIRED.  ALSO, EFFECTIVE WITH DATE OF SERVICE MAY 1, 2003, DENTAL PROVIDERS MAY ONLY BILL PROCEDURE CODES LISTED IN THE 2003 DENTAL FEE SCHEDULE LOCATED IN THE RECENTLY DISTRIBUTED PAGE REVISIONS TO THE DENTAL SERVICES PROVIDER MANUAL AND THE 2003 DENTAL SERVICES TRAINING PACKET!! 

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ATTENTION ALL HEMODIALYSIS PROVIDERS

PLEASE BE REMINDED THAT EFFECTIVE WITH CLAIM DATES OF SERVICE MAY 1,2003
PROCEDURE CODES Z6138(CALCITRIOL,2MCG)AND J0635(CALCIJEX {CALCITRIOL}) ARE NO LONGER PAYABLE. THE CORRECT CODE TO BILL FOR THIS SERVICE IS J0636 (CALCITRIOL.1MCG). THIS PROCEDURE CODE CROSSWALK WAS NOT CORRECTLY INDICATED IN THE TRAINING PACKETS DISTRIBUTED AT THE RECENT 2003  PROVIDER TRAINING WORKSHOPS. ALSO NOT MENTIONED IN THE TRAINING PACKET - LOCAL PROCEDURE CODE J0960 (DELATESTRYL INJECTION) SHOULD BE CROSSWALKED
TO CODE J3120 (TESTOSTERONE ENANTHATE INJECTION - UP TO 100 MG). 

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NOTICE TO PROVIDERS OF PROFESSIONAL SERVICES

EFFECTIVE WITH THE DATE OF SERVICE MAY 1, 2003, CPT CODE 90742(INJECTION
RHOGAM) WILL BE REPLACED CPT CODE J2790 (RHOGAM INJECTION, RHO D IMMUNE 
GLOBULE). CPT CODE 90742 WILL BE PLACED IN NON PAY STATUS EFFECTIVE WITH
DATE OF SERVICE MAY 1, 2003. 

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ATTENTION HOME AND COMMUNITY-BASED WAIVER SERVICES PROVIDERS

FOR INFORMATION ABOUT HOME AND COMMUNITY-BASED WAIVER SERVICES AS AN 
ALTERNATIVE LONG TERM CARE OPTION, PLEASE CALL 1-800-660-0488.