RA Messages for May 6, 2003
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 1/01/02 VERSION OF APPENDIX A:
DRUG |
DOSAGE |
STRGTH |
MAC |
EFF DATE |
ACETYLSTEINE |
VIAL/NEB |
200MG/ML |
OFF MAC |
05/11/03 |
ALPRAZOLAM |
TABLET |
0.25MG |
$0.06140 |
05/11/03 |
ALPRAZOLAM |
TABLET |
0.5MG |
$0.06980 |
05/11/03 |
ALPRAZOLAM |
TABLET |
1MG |
$0.08850 |
05/11/03 |
ALPRAZOLAM |
TABLET |
2MG |
$0.17450 |
05/11/03 |
AMILORIDE HCL/HCTZ |
TABLET |
5-50MG |
$0.06750 |
05/11/03 |
AMIODARONE HCL |
TABLET |
200MG |
$1.68750 |
05/11/03 |
AMITRIPTYLINE HCL |
TABLET |
150MG |
$0.24300 |
05/11/03 |
BUMETANIDE |
TABLET |
1MG |
$0.28140 |
05/11/03 |
BUMETANIDE |
TABLET |
2MG |
$0.47080 |
05/11/03 |
CHOLESTYRAMINE/ASP OR SUC |
PACKET |
4G |
$1.27670 |
05/11/03 |
CYCLOBENZAPRINE HCL |
TABLET |
1OMG |
$0.27280 |
05/11/03 |
DESOXIMETASONE |
CREAM(GM) |
0.25% |
$0.88660 |
05/11/03 |
DIFLUNISAL |
TABLET |
500MG |
OFF MAC |
05/11/03 |
HYDROXYZINE PAMOATE |
CAPSULE |
50MG |
$0.10130 |
05/11/03 |
LABETALOL HCL |
TABLET |
100MG |
$0.21470 |
05/11/03 |
LABETALOL HCL |
TABLET |
200MG |
$0.35820 |
05/11/03 |
LABETALOL HCL |
TABLET |
300MG |
$0.53630 |
05/11/03 |
METHOCARBAMOL |
TABLET |
500MG |
$0.19430 |
05/11/03 |
MINOCYCLINE HCL |
CAPSULE |
50MG |
$0.90000 |
05/11/03 |
MINOCYCLINE HCL |
CAPSULE |
100MG |
$1.80000 |
05/11/03 |
TEMAZEPAM |
CAPSULE |
15MG |
$0.13650 |
05/11/03 |
TEMAZEPAM |
CAPSULE |
30MG |
$0.17480 |
05/11/03 |
THEOPHYLLINE ANHYDROUS |
TAB.SR 12H |
100MG |
$0.12500 |
05/11/03 |
THEOPHYLLINE ANHYDROUS |
TAB.SR 12H |
200MG |
$0.25720 |
05/11/03 |
TOLAZAMIDE |
TABLET |
250MG |
$0.40050 |
05/11/03 |
VERAPAMIL HCL |
TABLET SA |
240MG |
$0.43500 |
05/11/03 |
PLEASE
MAKE THE FOLLOWING CHANGES TO THE 1/01/02 VERSION OF APPENDIX C:
LABELER |
COMPANY |
BEGIN |
END |
66887 |
AUXILIUM PHARMACEUTICALS INC |
7/01/03 |
|
67870 |
AXIOM PHARMACEUTICAL CORPORATION |
7/01/03 |
|
PLEASE
FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID
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.
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.
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).
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.
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.
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.