PLEASE MAKE THE FOLLOWING CHANGES TO THE 1/01/02 VERSION OF
APPENDIX C:
| LABELER |
COMPANY |
BEGIN |
END |
| 00033 |
SYNTEX LABORATORIES, INC |
|
10/01/02 |
| 00113 |
PERRIGO COMPANY |
|
10/01/02 |
| 00268 |
CENTER LABORATORIES |
|
10/01/02 |
| 00349 |
PARMED PHARM. |
|
10/01/02 |
| 00710 |
PFIZER PHARMACEUTICALS |
|
10/01/02 |
| 10797 |
LUITPOLD PHARM. |
|
10/01/02 |
| 50057 |
PHARMACEUTICAL VENTURES |
|
10/01/02 |
| 52446 |
QUALITEST PHARM. |
|
10/01/02 |
| 53124 |
PRAXIS BIOLOGICS |
|
10/01/02 |
| 53404 |
VINTAGE PHARM. |
|
10/01/02 |
| 57294 |
SMITHKLINE BEECHAM |
|
10/01/02 |
| 58441 |
INSOURCE, INC |
|
10/01/02 |
| 58728 |
PETERS LABORATORIES, INC |
|
10/01/02 |
| 63254 |
EM PHARMA |
|
10/01/02 |
| 64909 |
ZOETICA PHARMACEUTICAL CORPORATION |
|
10/01/02 |
| 66500 |
NOVAVAX, INC |
10/01/02 |
|
| 66582 |
MSP MARKETING SERVICES |
10/01/02 |
|
| 66758 |
PARENTA PHARM. |
10/01/02 |
|
| 66992 |
WRASER PHARM. |
10/01/02 |
|
| 67211 |
PHARMION CORPORATION |
10/01/02 |
|
PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID.
NOTICE TO ALL PROVIDERS
IN REGARDS TO THE FOLLOWING MESSAGE RELATED TO BILLING FOR EMERGENCY
ROOM SERVICES, SENT FOR THE WEEK OF 8/6/02 AND 8/13/02, THE PROGRAMMING FOR EMC WAS NOT COMPLETED WHEN THIS MESSAGE WAS SENT AND DATA PLACED IN
FORM LOCATOR 11 OF THE UB92 WAS NOT RECOGNIZED BY THE SYSTEM IF BILLED ELECTRONICALLY. THIS PROGRAMMING IS COMPLETED AND THE EMC PROVIDERS ARE
BEING NOTIFIED OF APPROPRIATE SOFTWARE BILLING CHANGES. PROVIDERS ARE RESPONSIBLE FOR RESUBMITTING FOR ANY CLAIMS THAT WERE NOT PROCESSED
CORRECTLY.
EFFECTIVE JULY 1, 2002,EMERGENCY DEPARTMENT PHYSICIAN VISITS OF MODERATE
TO HIGH COMPLEXITY (CPT 99283, 99284, AND 99285,99291, 99292, 99243, 99244, 99245), AND ASSOCIATED HOSPITAL SERVICES WILL BE EXEMPT FROM THE
COMMUNITYCARE POST-AUTHORIZATION PROCESS.
HOSPITALS BILLING FOR SERVICES ASSOCIATED WITH MODERATE TO HIGH LEVEL
EMERGENCY PHYSICIAN CARE, SHOULD PLACE A "3" IN FORM LOCATOR 11 ON THE UB92. MODERATE TO HIGH LEVEL COMPLEXITY SHOULD CORRESPOND TO THE LEVEL
OF CARE NOTED IN THE DEFINITION OF EVALUATION AND MANAGEMENT CPT CODES 99283, 99284, 99285. PROVIDERS ARE RESPONSIBLE FOR SUBMITTING ADJUSTMENTS FOR ANY CLAIMS PAID INCORRECTLY.
HOSPITALS BILLING FOR SERVICES ASSOCIATED WITH LOW LEVEL EMERGENCY PHYSICIAN CARE, SHOULD PLACE A "1" IN FORM LOCATOR 11 ON THE UB92. LOW LEVEL COMPLEXITY SHOULD CORRESPOND TO THE LEVEL OF CARE NOTED IN THE DEFINITION OF EVALUATION AND MANAGEMENT CPT CODES 99281, 99282. WHEN AN ENROLLEE IS HOSPITALIZED OR RECEIVES SERVICES IN THE ER, IT IS THE HOSPITAL'S RESPONSIBILITY TO ENSURE THAT THE PCP'S AUTHORIZATION NUMBER IS AVAILABLE FOR ANY OTHER PROVIDERS THAT WILL BILL MEDICAID FOR
SERVICES RELATED TO THE HOSPITAL ADMISSION OR ER VISIT.
NOTICE TO ALL PROVIDERS
THE DEPARTMENT OF HEALTH AND HOSPITALS IS CURRENTLY IN THE PROCESS OF
UPDATING MEDICAID PROVIDER FILES. THE RECORDS OF PROVIDERS WHO HAVE NOT PARTICIPATED, BILLED OR BEEN PAID BY LOUISIANA MEDICAID SINCE PRIOR TO
JUNE 30, 2001 WILL BE CLOSED. ANY PROVIDER CLOSED IN THIS AUTOMATIC UPDATE WILL BE REQUIRED TO RE-ENROLL IF THEY WISH TO PARTICIPATE IN THE
LOUISIANA MEDICAID PROGRAM.
NOTICE TO CLINICAL NURSE SPECIALISTS
EFFECTIVE AUGUST 1, 2002, CLINICAL NURSE SPECIALISTS ARE NOW AUTHORIZED
TO ENROLL IN THE LOUISIANA MEDICAID PROGRAM. PLEASE CALL 800/473-2783, OPTION 4 TO REQUEST AN ENROLLMENT PACKET.