RA Messages for September 21, 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 MAKE THE FOLLOWING CHANGES TO THE 8/15/98 VERSION OF
APPENDIX C:
| LABELER |
COMPANY |
BEGIN |
END |
| 11845 |
MASON
DISTRIBUTORS, INCORPORATED |
|
10/01/99 |
| 64764 |
TAKEDA
PHARMACEUTICALS AMERICA |
10/01/99 |
|
| 64909 |
ZOETICA
PHARMACEUTICAL CORPORTAION |
10/01/99 |
|
PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN
INCORRECTLY PAID
PHARMACY PROVIDERS
POS CLAIMS SUBMITTED WITH THE 16 DIGIT CARD HOLDER NUMBER (CCN)
AND A '2' IN THE 'ELIGIBILITY
OVERRIDE CLARIFICATION CODE' FIELD WILL DENY WITH
EDIT 215.
PHARMACISTS AND PHYSICIANS
NOTE: MEDICARE REQUIRES PHYSICIANS TO PROVIDE ICD-9
DIAGNOSIS CODES ON ALL CERTIFICATES
OF MEDICAL NECESSITY. ONLY ICD-9 CODES ARE ACCEPTABLE. THERE IS NO
PROVISION FOR NARRATIVE DIAGNOSIS. THEREFORE, EFFECTIVE FOR DATES OF SERVICE
10/01/99, LOUISIANA MEDICAID WILL ONLY ACCEPT ICD-9 DIAGNOSIS
CODES TO BE CONSISTENT WITH MEDICARE POLICY. ANY ORIGINAL PRESCRIPTION
BILLED PRIOR TO 10/01/99 WITH REFILLS REMAINING WILL HAVE PAYMENTS
FOR THOSE REFILLS GRANDFATHERED IF THE NARRATIVE DIAGNOSIS IS PRESENT
ON THE PRESCRIPTION HARD-COPY OR THE ATTACHMENT. HOWEVER, AFTER THE
AUTHORIZED REFILLS HAVE BEEN EXHAUSTED, ONLY ICD-9 DIAGNOSIS CODES
WILL BE THE ACCEPTABLE FORM OF DOCUMENTATION. ANY QUESTIONS CONCERNING THIS
CHANGE CAN BE DIRECTED TO THE POS HELP DESK AT 1-800-648-0790 OR (225)
237-3381.
ALL PROVIDERS
THIS IS A REMINDER THAT ACT 1142 OF THE 1997 REGULAR
SESSION OF THE LOUISIANA LEGISLATURE REQUIRES THAT LL MEDICAID RELATED RECORDS
BE RETAINED FOR A PERIOD OF FIVE (5) YEARS.
THE DEPARTMENT'S CONTACT PERSON FOR CIVIL RIGHTS ISSUES HAS
BEEN CHANGED. PROVIDERS MAY NOW CONTACT MS. EVELLA COLLINS AT
(225)342-3797.