RA Messages for August 31, 2004
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 NOTE THE FOLLOWING CHANGES TO APPENDIX B: (DESI'S)
| NDC |
TRADENAME |
DOSAGE |
| 62584-0139-00 |
EPIDRIN |
CAPSULE |
| 62584-0139-01 |
EPIDRIN |
CAPSULE |
| 62584-0139-18 |
EPIDRIN |
CAPSULE |
PLEASE NOTE THE FOLLOWING CHANGES TO APPENDIX C:
| LABELER |
COMPANY |
BEGIN |
END |
| 00314 |
HYDREX PHARMACEUTICALS |
|
04011991 |
| 19650 |
EVANS MEDICAL |
|
01012003 |
| 43567 |
MD PHARMACUTICAL |
|
04012003 |
| 51645 |
GEMINI PHARMACEUTICALS, INC. |
|
04012003 |
| 53169 |
BOEHRINGER MANHEIMM |
|
04012003 |
| 55422 |
PHARMAKON LABS,INC |
|
04012003 |
| 57459 |
NASTECH PHARMACEUTICAL COMPANY INC, |
|
07012004 |
| 60475 |
KERRY COMPANY,
THE |
|
04012003 |
| 61470 |
AMERX HEALTH CARE CORPORATION |
|
04012003 |
| 65779 |
FAIRVIEW HEALTH SERVICES |
|
04012003 |
| 66073 |
HEALZ-PLUS, INC |
|
04012003 |
| 67445 |
GRABEN PHARMA, INC |
|
04012003 |
PLEASE
FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID.
PREVACID NAPRAPAC UNIT BILLING ERRORS
PLEASE NOTE THAT PREVACID NAPRAPAC IS BILLABLE TO LOUISIANA MEDICAID
BY
THE TABLET/CAPSULE AND MUST BE BILLED IN MULTIPLES OF 21.
ATTENTION PHYSICIAN AND KIDMED PROVIDERS
EFFECTIVE 8/23/04, FOR CLAIM DATES OF SERVICE BEGINNING 10/1/03 FORWARD,
CLAIMS SUBMITTED USING PREVENTIVE MEDICINE PROCEDURE CODES 99381-99385 OR 99391-99395 MUST REFLECT THE CORRECT PROCEDURE CODE FOR THE AGE OF
THE CHILD. CLAIM EDITS ARE BEING PLACED IN THE CLAIMS PROCESSING LOGIC THAT WILL PREVENT PAYMENT OF THESE PROCEDURE CODES IF THEY ARE NOT
APPROPRIATE FOR THE AGE OF THE CHILD. PLEASE MAKE ANY NECESSARY CHANGES TO YOUR INTERNAL SYSTEMS OR PROCEDURES TO
ACCOMMODATE THIS PROCESSING CHANGE. QUESTIONS MAY BE DIRECTED TO PROVIDER RELATIONS AT 800-473-2783
OR 225-924-5040.
ATTENTION ALL EPSDT DENTAL PROVIDERS
EFFECTIVE SEPTEMBER, 1, 2004, THE RATES FOR CERTAIN DESIGNATED DENTAL
PROCEDURES WILL BE INCREASED AND A NEW PROCEDURE FOR RETREATMENT OF PREVIOUS ROOT CANAL THERAPY, ANTERIOR (D3346) WILL BE MADE PAYABLE AS A
RESULT OF THE ALLOCATION OF ADDITIONAL FUNDS BY THE LEGISLATURE DURING THE 2004 REGULAR SESSION. SPECIFIC INFORMATION REGARDING THE RATE
INCREASES AND THE POLICIES ESTABLISHED FOR PROCEDURE CODE D3346 WILL BE AVAILABLE ON THE FOLLOWING WEBSITE AS SOON AS
POSSIBLE: HTTP://WWW.LAMEDICAID.COM. IF YOU DO NOT HAVE INTERNET ACCESS AND NEED
TO REQUEST A HARDCOPY OF THIS INFORMATION ONCE IT IS AVAILABLE, YOU MAY CONTACT UNISYS PROVIDER RELATIONS BY CALLING (800)473-2783 OR (225) 924-5040.AS A REMINDER, PROVIDERS SHOULD BILL THEIR USUAL AND CUSTOMARY FEE.
ATTENTION ALL EXPANDED DENTAL SERVICES
FOR PREGNANT WOMEN (EDSPW) PROVIDERS
EFFECTIVE SEPTEMBER 1, 2004, THE RATES FOR CERTAIN DESIGNATED DENTAL PROCEDURES WILL BE INCREASED. SPECIFIC INFORMATION REGARDING THE RATE INCREASES WILL BE AVAILABLE ON THE FOLLOWING WEBSITE AS SOON AS POSSIBLE
HTTP://WWW.LAMEDICAID.COM. IF YOU DO NOT HAVE INTERNET ACCESS AND NEED TO REQUEST A HARDCOPY OF THIS INFORMATION ONCE IT IS AVAILABLE, YOU MAY CONTACT UNISYS PROVIDER RELATIONS AT (800)473-2783 OR (225) 924-5040. AS
A REMINDER, PROVIDER SHOULD BILL THEIR USUAL AND CUSTOMARY FEE.
ATTENTION DENTAL PROVIDERS
SOME DENTAL CLAIMS FOR PROCEDURE CODE D8220 (FIXED APPLIANCE THERAPY)
INADVERTENTLY DENIED WITH ERROR CODE 103(INVALID TOOTH CODE/ORAL CAVITY DESIGNATOR). THE PROBLEM THAT CAUSED THIS ERROR TO BE INCORRECTLY
REPORTED HAS BEEN CORRECTED. IN THE NEAR FUTURE, THESE CLAIMS WILL BE AUTOMATICALLY RECYCLED BY MEDICAID AND WILL APPEAR ON YOUR REMITTANCE
ADVICE. SHOULD YOU HAVE ANY QUESTIONS RELATED TO THIS MATTER, YOU MAY CONTACT UNISYS PROVIDER RELATIONS BY CALLING (800) 473-2783 OR
(225) 924-5040.
ATTENTION DME PROVIDERS
WE WANT TO REMIND ALL DURABLE MEDICAL EQUIPMENT (DME) PROVIDERS THAT THE
DATE OF SERVICE ON CLAIMS MUST ALWAYS REFLECT THE ACTUAL DATE OF DELIVERY. IT IS A VIOLATION OF MEDICAID POLICY TO SUBMIT A REQUEST FOR
PAYMENT PRIOR TO THE DATE OF DELIVERY OR TO SHOW THE DATE OF SERVICE AS ANY DATE OTHER THAN THE ACTUAL DATE OF DELIVERY.