RA Messages for September 26, 2000
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 5/15/00 VERSION OF
APPENDIX A:
| DRUG |
DOSAGE |
STRGTH |
MAC |
EFF.DATE |
| PROPANTHELINE BROMIDE |
TAB |
15MG |
OFF MAC |
09/20/00 |
| TESTOSTERONE CYPIONATE |
VIAL |
200MG/ML |
OFF MAC |
09/01/00 |
PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN
INCORRECTLY PAID
NOTICE TO PROVIDERS OF PROFESSIONAL SERVICES
THE LOUISIANA MEDICAID PROGRAM WILL REIMBURSE SURGEONS FOR THE USE OF AN
OPERATING MICROSCOPE (CPT CODE 69990) ONLY IN SITUATIONS WHICH JUSTIFY ITS
USE. SOME CLAIMS HAVE BEEN RECEIVED FROM PROVIDERS BILLING FOR CODE 69990
IN ADDITION TO CODE 69436 (TYMPANOSTOMY, GENERAL ANESTHESIA). IF A
PROCEDURE IS CONSIDERED ROUTINE BY THE PHYSICIAN - CONSULTANTS, CODE 69990 WILL
BE DENIED WITH ERROR EDIT 774 - INCLUDED IN RELATED PROCEDURE.