RA Messages for September 14, 1999


 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 8/15/98 VERSION OF APPENDIX A:

DRUG  DOSAGE  STRGTH MAC EFF.DATE
FLUOXETINE HCL CAPSULE 40MG   09/19/99
IVERMECTON   TABLET 3MG   09/01/99
KETOTIFEN FUMARATE DROPS 0.025%   09/15/99
LIDOCAINE HCL  CREAM 3%   08/23/99
SOMATROPIN  CARTRIDGE   18U;72U    08/23/99
TEMOZOLOMIDE CAPSULE 5MG;20MG;100MG;250MG   08/17/99
ZANAMIVIR DISK W/DEV  5MG    09/15/99

PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID


PHARMACY PROVIDERS--XENICAL DIAGNOSIS CLARIFICATION --EDIT #020 

       

THE DIAGNOSIS ICD-9 CODE SUBMITTED ON A PRESCRIPTION CLAIM MUST MATCH  EXACTLY THE ICD-9 DIAGNOSIS CODE WRITTEN BY THE PRESCRIBER ON THE PRESCRIPTION. DHH WILL ONLY PAY FOR VALID ICD-9 CODES LISTED IN THE MOST CURRENT ICD-9-CM TEXT.


Notice to Home Health Agencies
FIMS # 55779

The June/July issue of the Louisiana Medicaid Provider Update includes an article to Home Health Agencies entitled "RN Qualifications for Psychiatric Home Health Visits."

The last paragraph of this article includes an incorrect statement./  The correct wording of the last paragraph is "Additionally , the services must be medically necessary and provided only to recipients who meet Medicaid's homebound criteria."

We apologize for any inconvenience this may have caused.


All Providers
FIMS #5780

Thisi s a reminder that Act 1142 of the 1997 Regular Session of the Louisiana Legislature requires that all Medicaid related records be retained for a period of  (5) years.

The Department's contact person for civil rights issues has changed.  Providers may now contact Ms. Evella Collins at (225)342-3797.


All Providers

This check write, dates 9/14/99, includes a recycle of outpatient hospital claims that were previously denied in error with error edit 251 (procedure denied, not justified by diagnosis)."