RA Messages for May 8, 2007

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 FILE ADJUSTMENTS FOR CLAIMS THAT MAY HAVE BEEN INCORRECTLY PAID. ONLY THOSE PRODUCTS OF THE MANUFACTURERS WHICH PARTICIPATE IN THE FEDERAL REBATE PROGRAM WILL BE COVERED BY THE MEDICAID PROGRAM. PARTICIPATION MAY BE VERIFIED IN APPENDIX C, AVAILABLE AT WWW.LAMEDICAID.COM

ATTENTION PROVIDERS

EFFECTIVE 7-2-2007, IN ACCORDANCE WITH A RECENT DHH DIRECTIVE, UNISYS WILL NO LONGER ACCEPT COPIES OF STANDARD CLAIM FORMS, THE REGULATIONS DO NOT ALLOW THE COPYING OF HARDCOPY CLAIM FORMS. THESE INCLUDE THE UB-92, UB-04, CMS 1500 (12-90), CMS 1500 (08-05), ADA, AND THE NCPDP UNIVERSAL CLAIM FORM. ANY HARD COPY CLAIMS SUBMITTED TO UNISYS FOR PROCESSING MUST BE AN ORIGINAL, STANDARD CLAIM FORM AND MUST MEET THE LICENSURE/ COPYRIGHT REQUIREMENTS OF THE PARTICULAR ORGANIZATION THAT REGULATES THAT CLAIM FORM. THIS INCLUDES ORIGINAL SUBMISSIONS, RE-SUBMISSIONS OF PREVIOUS CLAIMS, AND CLAIM ADJUSTMENTS/VOIDS.

WITH THE IMPLEMENTATION OF THIS REQUIREMENT, PROVIDERS THAT ARE ROUTINELY BILLING ALL CLAIMS HARD COPY MAY WANT TO CONSIDER TRANSITIONING TO ELECTRONIC CLAIMS SUBMISSION. QUESTIONS CONCERNING EDI BILLING MAY BE DIRECTED TO THE UNISYS EDI DEPARTMENT AT 225/216-6000, OPTION 2. A COMPLETE LISTING OF APPROVED EDI VENDORS IS AVAILABLE ON THE LA MEDICAID WEB SITE, WWW.LAMEDICAID.COM, LINK HIPAA INFORMATION CENTER/LINK VBC LIST. PLEASE CONTACT THE VENDORS FOR SPECIFIC INFORMATION ON THEIR SERVICES AS A WIDE RANGE OF PACKAGES/FEES ARE AVAILABLE.

ATTENTION PROVIDERS

THE 2007 HCPCS CODES HAVE BEEN LOADED TO OUR FILES AND MAY BE SUBMITTED FOR DATES OF SERVICE JANUARY 1, 2007 FORWARD. LOOK FOR THE UPDATED 2007 FEE SCHEDULE ON THE LOUISIANA MEDICAID WEBSITE, WWW.LAMEDICAID.COM, IN THE NEAR FUTURE.

ATTENTION PROVIDERS - NATIONAL PROVIDER IDENTIFIER

DHH HAS LAUNCHED A NEW NPI WEB REGISTRATION SITE FOR PROVIDERS TO REGISTER THEIR NPI WITH LOUISIANA MEDICAID. CMS WILL REQUIRE ALL HIPAA STANDARD TRANSACTIONS, INCLUDING MEVS ELIGIBILITY INQUIRY AND CLAIMS STATUS INQUIRY TO BE SUBMITTED USING THE NPI NUMBER BEGINNING 23-MAY-07. THE NEW NPI APPLICATION IS ACCESSIBLE FROM THE LIST OF APPLICATIONS IN THE SECURED PROVIDER AREA OF THE WWW.LAMEDICAID.COM WEB SITE. FIND THIS AND MORE ON THE NPI INFORMATION PAGE ACCESSIBLE FROM WWW.LAMEDICAID.COM>
HIPAA INFORMATION CENTER>NATIONAL PROVIDER IDENTIFIER (NPI).

ATTENTION ASSISTANT SURGEONS

PROCEDURE CODE 36819 (ARTERIOVENOUS ANASTOMOSIS, OPEN; BY UPPER ARM BASILIC VEIN TRANSPOSITION) HAS BEEN MADE PAYABLE EFFECTIVE JULY 1, 2006 FOR ASSISTANT SURGEONS. CLAIMS FOR ASSISTANT SURGEON SERVICES FOR THIS PROCEDURE FOR DATES OF SERVICE JULY 1, 2006 FORWARD MAY BE SUBMITTED TO UNISYS FOR ADJUDICATION.

ATTENTION HOSPITALS - NEW OBSERVATION CODES

EFFECTIVE FOR DATES OF SERVICE ON OR AFTER MAY 1, 2007, HOSPITALS ARE DIRECTED TO BILL REVENUE CODE 762 (OBSERVATION) USING ONLY CODES G0378 OR G0379 IN THE HCPC FIELD AS DEEMED NECESSARY FOR OBSERVATION.

ATTENTION HOSPITALS - WHEELCHAIR SEATING EVALUATION REVENUE CODE

EFFECTIVE FOR DATES OF SERVICE ON OR AFTER MAY 1, 2007, PROVIDERS WILL NO LONGER BE ALLOWED TO BILL WHEELCHAIR SEATING EVALUATIONS WITH REVENUE CODE 454. ACCORDING TO NATIONAL UNIFORM BILLING, THIS CODE IS NO LONGER VALID.