RA Messages for July 3, 2001
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
12/9/00 VERSION OF APPENDIX A:
| DRUG |
DOSAGE |
STRGTH |
MAC |
EFF. DATE |
| AMITRIPTYLINE HCL |
TAB |
50MG |
0.06660 |
06/13/01 |
| DIFLUNISAL |
TAB |
500MG |
0.51350 |
06/13/01 |
| DIPYRIDAMOLE |
TAB |
75MG |
0.13590 |
06/13/01 |
| HALOPERIDOL |
TAB |
0.5MG |
OFF MAC |
06/13/01 |
| HALOPERIDOL |
TAB |
1MG |
OFF MAC |
06/13/01 |
| HALOPERIDOL |
TAB |
2MG |
OFF MAC |
06/13/01 |
| HALOPERIDOL |
TAB |
5MG |
OFF MAC |
06/13/01 |
| HYDROCODONE BIT/APAP |
TAB |
7.5MG-500MG |
0.23400 |
06/13/01 |
| METOCLOPRAMIDE HCL |
TAB |
10MG |
0.10950 |
06/13/01 |
| NEOMY SULF/GRAMICID |
D/POLY DROPS |
|
2.21850 |
06/13/01 |
| PRAZOSIN HCL |
CAP |
1MG |
0.13350 |
06/13/01 |
| PRAZOSIN HCL |
CAP |
2MG |
0.26920 |
06/13/01 |
| PRAZOSIN HCL |
CAP |
5MG |
0.43280 |
06/13/01 |
| PREDNISOLONE SOD PHOS |
DROPS |
1% |
OFF MAC |
06/13/01 |
| PREDNISONE |
TAB |
1MG |
OFF MAC |
07/01/01 |
| THEOPHYLLINE ANHYDROUS |
TAB |
TAB SR 12H 200MG |
0.12840 |
06/13/01 |
| THEOPHYLLINE ANHYDROUS |
TAB |
TAB SR 12H 300MG |
0.13130 |
06/13/01 |
| THEOPHYLLINE ANHYDROUS |
TAB |
TAB SR 12H 450MG |
OFF MAC |
06/13/01 |
| VERAPAMIL
HCL |
TAB SA |
240MG |
0.35930 |
06/13/01 |
PLEASE
MAKE THE FOLLOWING CHANGES TO THE 12/9/00 VERSION OF APPENDIX C:
| LABELER |
COMPANY |
BEGIN |
END |
| 55422 |
PHARMAKON LABS, INC |
10/01/01 |
|
| 64108 |
OPTICS LABORATORY, INC |
10/01/01 |
|
| 66073 |
HEALZ-PLUS,
INC |
10/01/01 |
|
PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH
MAY HAVE BEEN INCORRECTLY PAID
NOTICE TO DENTAL PROVIDERS
CLARIFICATION OF ADULT DENTURE PROGRAM - PARTIAL DENTURE POLICY THIS NOTICE IS
TO PROVIDE CLARIFICATION OF EXISTING ADULT DENTURE PROGRAM
-PARTIAL DENTURE POLICY WHICH CAN BE FOUND ON PAGES 5-12 AND 5-13 OF THE MEDICAID DENTAL SERVICES MANUAL.
REMOVABLE ACRYLIC PARTIAL DENTURES WILL ONLY BE PROVIDED AS A PROGRAM BENEFIT IN THE FOLLOWING SELECT INSTANCES:1)THE PARTIAL DENTURE MUST
OPPOSE A FULL DENTURE; AND 2)THE RECIPIENT MUST BE MISSING AT LEAST TWO ANTERIOR TEETH, OR MISSING AT LEAST FOUR POSTERIOR TEETH ON EITHER SIDE
OF THE ARCH FOR WHICH THE PARTIAL DENTURE IS REQUESTED; AND 3)THE POTENTIAL ABUTMENT TEETH SHOULD BE CARIES FREE OR PROPERLY RESTORED,
PERIODONTIALLY SOUND TO LAST FOR SEVEN YEARS. ON PARTIAL DENTURE AND ONE RELINE PER ARCH ARE ALLOWED IN A SEVEN-YEAR
PERIOD. THE DELIVERY OF A PARTIAL DENTURE PREVENTS AN AUTHORIZATION OF A COMPLETE DENTURE FOR THAT ARCH FOR SEVEN YEARS. THE
PROGRAM DOES NOT PROVIDE OR FUND TWO PARTIALS IN THE SAME ORAL CAVITY.
SHOULD YOU HAVE ANY QUESTIONS REGARDING THIS POLICY, YOU MAY CONTACT THE LSU SCHOOL OF DENTISTRY BY CALLING 504-619-8589.
NOTICE TO PROVIDERS OF PROFESSIONAL
SERVICES
THE CPT CODES WHICH WERE DISCONTINUED IN THE
YEAR 2001 ISSUANCE OF THE CURRENT PROCEDURAL TERMINOLOGY WILL BE PLACED IN
NON-PAY STATUS ON OUR FILES EFFECTIVE WITH DATE OF SERVICE JULY 1, 2001.
PLEASE PROGRAM ACCORDINGLY.
CORRECTION TO PREVIOUS NOTICE
NOTICE TO PROVIDERS OF PROFESSIONAL SERVICES
IN A PREVIOUS NOTICE, THE PRICE FOR
PROFESSIONAL SERVICES CODE 88358 WAS STATED AS $199.83. THIS WAS AN ERROR.
THE ACTUAL PRICE FOR THIS CODE IS $119.83.
NOTICE TO PROVIDERS OF PROFESSIONAL
SERVICES
THE FEE FOR CPT CODE 46740 (REPAIR OF HIGH
IMPERFORATE ANUS WITH RECTOURETHRAL OR RECTOVAGINAL FISTULA; PERINEAL OR
SACROPERINEAL APPROACH) WAS INCREASED TO $1, 086.87 EFFECTIVE WITH DATE OF
SERVICE JUNE 1, 2001.
NOTICE TO PCS/PCA PROVIDERS
THE BUREAU WILL HOLD ANOTHER TRAINING IN JULY
FOR PCS/PCA PROVIDERS THAT PROVIDE PCS TO NON-WAIVER RECIPIENTS UNDER AGE 21.
THE TRAINING WILL FOCUS ON COVERED SERVICES AND THE PRIOR AUTHORIZATION PROCESS.
THE DATE OF THE TRAINING IS JULY 13, 2001 AND WILL BE HELD IN ALEXANDRIA.
PROVIDERS WISHING TO ATTEND THE TRAINING MUST
CALL TO REGISTER. PLEASE CALL KAYLIN HAYNES AT 225-342-4182.
2001 TRAINING SESSIONS
PROVIDER TRAINING SESSIONS WILL BE HELD ON THE FOLLOWING DATES:
BATON ROUGE - SEPT. 11 AND 13 (NOTE THIS IS A TUESDAY AND THURSDAY)
COVINGTON - SEPT. 14
HOUMA - SEPT. 19 (WEDNESDAY)
NEW ORLEANS - SEPT. 20 AND 21 (THURSDAY AND FRIDAY)
ALEXANDRIA - SEPT. 26 AND 27 (WEDNESDAY AND THURSDAY)
MONROE - OCT. 1 AND 2 (MONDAY AND TUESDAY)
BOSSIER CITY - OCT. 8 AND 9 (MONDAY AND TUESDAY)
LAFAYETTE - OCT. 8 AND 9 (MONDAY AND TUESDAY)
LAKE CHARLES - OCT. 10 AND 11 (WEDNESDAY AND THURSDAY)
WATCH FOR A COMPLETE SCHEDULE OF LOCATIONS AND DATES IN THE AUGUST
EDITION OF THE PROVIDER UPDATE.