RA Messages for June 12, 2007

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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.

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ATTENTION PHYSICIANS

THE FOLLOWING CPT CODES WILL BE ADDED TO THE LIST OF CODES THAT REQUIRE A QW MODIFIER, EFFECTIVE 01/01/2007.
G0328 QW - FECAL BLOOD SCRN IMMUNOSSAY
83655 QW- ASSAY BLOOD FOR LEAD

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ATTENTION PROVIDERS

LOUISIANA MEDICAID HAS RECYCLED THE CLAIMS SUBMITTED USING 2007 HCPCS CODING AND SUBSEQUENTLY DENIED WITH ERROR CODE 232 (PROCEDURE CODE NOT COVERED) WHEN THE CLAIMS WERE SUBMITTED PRIOR TO THE LOADING OF THE 2007 HCPCS CODES ONTO THE MEDICAID SYSTEM. THIS RECYCLE APPEARS ON THE REMITTANCE ADVICE DATED 5/22/07. A RECYCLE DOES NOT ASSURE PAYMENT; CLAIMS MAY DENY FOR OTHER EDITS IN THE CLAIMS PROCESSING SYSTEM.

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ATTENTION PROFESSIONAL SERVICES PROVIDERS

BASED ON FUNDING APPROPRIATED IN THE 2006 LEGISLATIVE SESSION AND APPROVAL BY CMS, DHH IS PLEASED TO ANNOUNCE INCREASES IN THE REIMBURSEMENT RATE FOR SELECTED GROUPS OF CPT PROCEDURE CODES, INCLUDING CERTAIN OUTPATIENT EVALUATION AND MANAGEMENT, EMERGENCY DEPARTMENT, OUTPATIENT CONSULTATION, PREVENTIVE MEDICINE, AND GENERAL/ INTEGUMENTARY SYSTEM CODES. THE INCREASES ARE EFFECTIVE WITH DATE OF SERVICE OCTOBER 4, 2006, FORWARD.

CLAIMS PAID AT THE LOWER RATE WILL BE SYSTEMATICALLY RECYCLED. DUE TO THE LARGE CLAIMS VOLUME, THE RECYCLE WILL OCCUR IN THREE WEEKLY CYCLES, IN NUMERICAL ORDER BY BILLING PROVIDER NUMBER, BEGINNING WITH THE RA OF JUNE 12, 2007. CLAIMS FOR BILLING PROVIDERS WILL APPEAR ON ONLY ONE OF THE THREE RAS. PLEASE REVIEW YOUR RAS TO DETERMINE WHICH DATE YOUR CLAIMS WERE RECYCLED.

THESE RATE INCREASES WILL ALSO BE REFLECTED ON THE PROFESSIONAL SERVICES FEE SCHEDULE POSTED ON THE LA MEDICAID WEB SITE, WWW.LAMEDICAID.COM, LINK FEE SCHEDULES.