RA Messages for August 3, 2004

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ATTENTION ALL VISION (EYE WEAR) PROVIDERS

UNDER THE CURRENT BILLING POLICY FOR EYE WEAR SERVICES, THE ONLY ACCEPTABLE MODIFIERS ARE "LT" FOR LEFT AND "RT" FOR RIGHT. BILLING INAPPROPRIATE MODIFIERS WILL CAUSE THE CLAIM TO DENY. PLEASE MAKE ANY CHANGES NECESSARY IN YOUR BILLING SYSTEM TO ENSURE THAT THE APPROPRIATE MODIFIERS ARE BEING BILLED. THESE MODIFIERS SHOULD ONLY BE USED WHEN BILLING PROCEDURE CODE V2102 WHEN THE STRENGTH IS OVER 12.00 SPHERE. WHEN BILLING PROCEDURE CODE V2102 WHEN THE STRENGTH IS 7.12 TO 12.00 SPHERE, OR ANY OTHER EYE WEAR PROCEDURE CODE, NO MODIFIER SHOULD BE USED. BILLING
WITH MODIFIERS WHEN THEY ARE NOT REQUIRED MAY CAUSE PROBLEMS WITH THE PAYMENT OF YOUR CLAIM. PROVIDERS MUST DOCUMENT WHETHER THE REQUESTED LENS IS FOR THE RIGHT EYE OR THE LEFT EYE IN THE PATIENT'S RECORD. IN ADDITION, WHEN BILLING TWO UNITS OF A SINGLE PROCEDURE CODE, IT SHOULD BE REPORTED ON A SINGLE CLAIM LINE INDICATING THE CORRECT NUMBER OF UNITS; HOWEVER, TWO SEPARATE CLAIM LINES ARE REQUIRED IF ONE LENS REQUIRES PRIOR AUTHORIZATION AND ONE DOES NOT. IF YOU HAVE ANY QUESTIONS REGARDING THIS MATTER, YOU MAY CONTACT UNISYS PROVIDER RELATIONS BY CALLING (800) 473-2783 OR 225-924-5040.

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NOTICE TO ALL MEDICAID PROVIDERS

THE DEPARTMENT OF HEALTH AND HOSPITALS HAS RECENTLY REVISED THE PE-50 SUPPLEMENT COMMUNITYCARE PROVIDER ENROLLMENT AGREEMENT. THIS REVISED AGREEMENT IS AVAILABLE ON THE COMMUNITYCARE WEB SITE - WWW.LA-COMMUNITYCARE.COM. EFFECTIVE IMMEDIATELY, ALL PROVIDERS SHOULD BEGIN UTILIZING THE REVISED AGREEMENT, AS THE STATE WILL NOT ACCEPT THE OLD AGREEMENT AFTER JULY 31, 2004. PROVIDERS WHO DO NOT HAVE INTERNET ACCESS MAY OBTAIN COPIES OF THE AGREEMENT BY CONTACTING UNISYS PROVIDER RELATIONS AT 800-473-2783. 

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NOTICE TO PROFESSIONAL SERVICE PROVIDERS

FEES WHICH WERE INCORRECTLY LOADED FOR PROCEDURE CODE G0317, G0318, G0319 AND G0327 HAVE BEEN REVISED. RECYCLE OF PREVIOUSLY DENIED CLAIMS AND ADJUSTMENT OF PREVIOUSLY PAID CLAIMS WILL APPEAR ON FORTHCOMING REMITTANCE ADVICES. 

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NOTICE TO PROFESSIONAL SERVICE PROVIDERS

PROCEDURE CODE 59409 HAS BEEN MADE PAYABLE EFFECTIVE MARCH 1, 2003. PREVIOUSLY DENIED CLAIMS WILL BE RECYCLED BY THE DEPARTMENT AND WILL APPEAR ON A REMITTANCE ADVICE IN THE NEAR FUTURE. THE REIMBURSEMENT FOR THIS CODE WILL BE $697.26. WHEN THIS CODE WAS IMPLEMENTED, THE REIMBURSEMENT FOR CPT CODE 59410 WAS INADVERTENTLY REDUCED TO $697.23. ALL CLAIMS FOR CPT 59410 THAT PAID AT THIS REDUCED RATE WILL BE RECYCLED AND ADJUSTED TO RECEIVE THE CORRECT REIMBURSEMENT OF $774.00 ON A REMITTANCE ADVICE IN THE VERY NEAR FUTURE.