RA Messages for May 9, 2000
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
PHARMACIES AND PRESCRIBERS:
AN UPDATED VERSION OF THE APPENDICES A, B, AND C WILL BE
MAILED SHORTLY.
THE NEW FEDERAL UPPER LIMITS, EFFECTIVE 6/1/00 ARE REFLECTED IN APP. A
NOTICE TO HOSPITALS
LOUISIANA MEDICAID DOE SNOT COVER ABORTED PROCEDURES, NOR ANY CHARGES RELATED TO THE ABORTED PROCEDURE.
NOTICE TO HOSPITALS
EFFECTIVE IMMEDIATELY, THE ONE-TIME SPLIT-BILLING REQUIREMENT FOR DATES OF SERVICE MARCH 1, MARCH 8, AND MARCH 23, IS NO LONGER A REQUIREMENT IN ADDITION, ANY CLAIMS FOR THE ABOVE DATES OF SERVICE DENIED WITH ERROR
CODE 300 SHOULD NOT BE RE-SUBMITTED. IF ADDITIONAL ASSISTANCE IS REQUIRED, PLEASE CONTACT UNISYS PROVIDER RELATIONS AT (800)473-2783, OR (225)924 - 5040.
NOTICE TO HOME HEALTH AGENCIES
WHEN SERVICES ARE PROVIDED BY A PHYSICAL THERAPIST ASSISTANT OR AN LPN, HOME HEALTH AGENCIES ARE TO IDENTIFY THESE SERVICES BY USING THE FOLLOWING CODES WHEN REQUESTING PRIOR AUTHORIZATION AND IN BILLING. THESE CODES WERE ESTABLISHED EFFECTIVE WITH DATE OF SERVICE 2-1-00.
| SERVICE CODE |
PROCEDURE CODE |
DESCRIPTION OF PROCEDURE CODE |
FEE |
| G= |
X9910 |
INITIAL SKILLED NURSING VISIT (LPN) |
$68.65 |
| L= |
X9936 |
INITIAL PHYSICAL THERAPY VISIT (PT ASSIST) |
$70.46 |
| I= |
X9913 |
SKILLED NURSING VISIT AFTER INITIAL VISIT
(LPN)(LIMIT 3 PER DAY) |
$68.65 |
| J= |
X9915 |
PHYSICAL THERAPY VISIT AFTER INITIAL VISIT (PT ASSIST) |
$70.46 |
| K= |
X9916 |
INITIAL SKILLED NURSING VISIT FOR MULTIPLE RECIPIENTS (LPN) |
$34.32 |
THE PROCEDURE FOR REQUESTING PRIOR AUTHORIZATION AND BILLING FOR THE FIRST HOUR OF EXTENDED CARE REMAINS THE SAME AS PROCEDURES IN PLACE
PRIOR TO 2-1-00. THE ONLY CHANGE IS THE NEW CODES ARE NOW REQUIRED WHEN A SERVICE IS PROVIDED BY AN LPN OR A PHYSICAL THERAPIST ASSISTANT.
IF ADDITIONAL ASSISTANCE IS REQUIRED, PLEASE CONTACT UNISYS PROVIDER RELATIONS AT (800)473-2783, PR (225)924-5040.