RA Messages for July 15, 2003

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PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID.

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PRESCRIBING PROVIDERS AND PHARMACY PROVIDERS

IN THE RECENT JULY 14, 2003 CORRESPONDENCE MAILED TO ALL PRESCRIBING AND PHARMACY PROVIDERS, A PDL LIST "03-04" WAS INCLUDED. THE "03-04" LIST INCLUDES CHANGES THAT WERE MADE TO THE PDL AT THE MAY 21, 2003 P&TEETING. A CURRENT PDL LIST IS AVAILABLE ON THE LAMEDICAID.COM WEBSITE.

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ATTENTION HOME AND COMMUNITY-BASED WAIVER SERVICES PROVIDERS

FOR INFORMATION ABOUT HOME AND COMMUNITY-BASED WAIVER SERVICES AS AN 
ALTERNATIVE LONG TERM CARE OPTION, PLEASE CALL 1-800-660-0488.

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ATTENTION ALL MENTAL HEALTH REHAB PROVIDERS

THIS IS A REMINDER THAT IT IS AGAINST POLICY TO SOLICIT RECIPIENTS INTO ENROLLING WITH YOUR AGENCY.

PLEASE REFER TO SECTION 12-5, SECTION A, ITEM 4 OF THE JULY 1, 1999 ISSUE OF THE MENTAL HEALTH REHABILITATION MANUAL WHICH STATES THAT THE SOLICITATION OR SUBSIDIZATION OF ANYONE BY PAYING OR PRESENTING ANY PERSON MONEY OR ANYTHING OF VALUE FOR THE PURPOSE OF SECURING PATIENTS MAY CONSTITUTE SUFFICIENT GROUNDS FOR A PROVIDER ABUSE OR OTHER INCORRECT PRACTICES REFERRAL.

ANY SUSPICION OF THIS KIND OF ACTIVITY WILL BE REPORTED IMMEDIATELY TO THE DEPARTMENT'S PROGRAM INTEGRITY.

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TWO DIGIT PLACE OF SERVICE CODES REQUIRED

AS HIPAA IMPLEMENTATION CONTINUED AND WE WORK TOWARD THE REQUIRED STANDARDIZATION OF CODE SETS, IT IS NECESSARY TO REQUIRE PROVIDERS WHO REPORT PLACE OF SERVICE CODES TO BEGIN USING TWO-DIGIT CODES WHEN COMPLETING CLAIM FORMS. THE OLD ONE-DIGIT PLACE OF SERVICE CODES DO NOT MEET HIPAA REQUIREMENTS AND MAY NO LONGER BE USED WHEN BILLING MEDICAID EFFECTIVE OCTOBER 16, 2003. PLEASE MAKE IMMEDIATE PLANS TO HAVE ANY BILLING SOFTWARE USING THE ONE-DIGIT CODES CONVERT TO THE TWO-DIGIT CODE SET. 

REHABILITATION CENTERS WILL CONTINUE TO BILL THE APPROPRIATE ONE-DIGIT CODES CURRENTLY ACCEPTED ON HARDCOPY FORMS UNTIL FURTHER NOTICE. ALL PROVIDERS THAT ELECT TO BEGIN USING THE HIPAA 837 PROFESSIONAL FORMAT EFFECTIVE JULY 7, 2003 ARE REQUIRED TO USE THE HIPAA STANDARD TWO-DIGIT PLACE OF SERVICE CODES. SHOULD YOU HAVE QUESTIONS CONCERNING THIS TRANSITION, PLEASE CONTACT UNISYS PROVIDER RELATIONS AT 800-473-2783 OR 225-924-5040. 

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ALL PROVIDERS

THE DEPARTMENTS OF HEALTH AND HOSPITALS AND THE GOVERNOR'S COUNCIL ON 
PHYSICAL FITNESS AND SPORTS WILL JOIN FORCES WITH THE U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES, REGION VI AND OTHER HEALTH AND SOCIAL SERVICES  EXPERTS NATIONWIDE THE COME UP WITH SOLUTIONS TO THE COUNTRY'S  ESCALATING OBESITY RATES, BY SPONSORING AN OBESITY CONFERENCE ON AUGUST 7-8 AT THE HYATT REGENCY IN NEW ORLEANS. 

FOR MORE INFORMATION ABOUT THE CONFERENCE PLEASE CALL 225-342-4886 OR BY E-MAIL AT WORKSHOP@JBA-CHT.COM. REGISTRATION FORMS ARE LOCATED AT THIS SITE: HTTP://WWW.DHH.STATE.LA.US/PDF/IT/REGISTRATIONFORM.PDF 

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NOTICE TO PROVIDERS OF PROFESSIONAL SERVICES

EFFECTIVE WITH THE DATE OF SERVICE MAY 1, 2003, CPT CODES 82274, 83518, 
AND 87210 CAN BE BILLED BY PROVIDERS HOLDING CLIA CERTIFICATE TYPES 2&4.
THESE CODES REQUIRE A QW MODIFIER. 

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NOTICE TO CNPS AND CNSS

EFFECTIVE WITH THE DATE OF SERVICE MAY 1, 2003, THE FOLLOWING CPT CODES 
WERE ADDED TO THE LIST OF CODES PAYABLE TO CNPS AND CNSS. 

82270, 82947, 86580, 20610, 76810.