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.