RA Messages for September 28, 2004

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PLEASE NOTE THE FOLLOWING CHANGES TO APPENDIX C:

LABELER	COMPANY	BEGIN	END
08290	BD BECTION DICKINSON		10/01/04
61073	AMKAS LABORATORIES		10/01/04
63807	EXCELSIOR MEDICAL CORP		10/01/04
65759	D&K HEALTHCARE RESOURCES, INC.		10/01/04
66378	PRESUTTI LABORATORIES, INC.	10/01/04
68188	ALLIANT PHARMACEUTICALS	10/01/04
68712	JSJ PHARMACEUTICALS	10/01/04
68782	EYETECH PHARMACEUTICALS	10/01/04

PLEASE FILE ADJUSTMENTS FOR CLAIMS WHICH MAY HAVE BEEN INCORRECTLY PAID.

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ATTENTION EPSDT HEALTH SERVICES PROVIDERS

THIS MESSAGE CORRECTS THE PROCEDURE CODES FOR PSYCHOLOGICAL EVALUATION/ RE-EVALUATION GIVEN IN THE 2004 EPSDT HEALTH SERVICES TRAINING PACKET FOR HIPAA IMPLEMENTATION. MEDICAID LOCAL CODE X0413 WAS ERRONEOUSLY MAPPED TO "NEW HIPAA CODES" 90801 OR 90802. THE CORRECT HIPAA COMPLIANT CROSS-REFERENCE FOR LOCAL CODE X0413(PSYCHOLOGICAL EVAL/RE-EVAL) IS CPT CODE 96100(PSYCHOLOGICAL TESTING....WITH INTERPRETATION AND REPORT). PROVIDERS WHO HAVE PREVIOUSLY SUBMITTED CLAIMS USING THE "NEW HIPAA CODES" 90801 OR 90802 LISTED IN THE TRAINING PACKET SHOULD NOT VOID THESE CLAIMS. HOWEVER, EFFECTIVE SEPTEMBER 20, 2004, CPT CODE 90801 AND 90802 SHOULD NO LONGER BE USED FOR PSYCHOLOGICAL EVALUATIONS FOR EPSDT HEALTH SERVICES PROVIDERS. 

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ATTENTION DENTAL PROVIDERS

EFFECTIVE OCTOBER 1, 2004, MEDICAID WILL BEGIN CAPTURING THE INFORMATION REPORTED ON THE 2002 AMERICAN DENTAL ASSOCIATION (ADA) CLAIM FORM, BLOCK 23 {PATIENT ID/ACCOUNT # (ASSIGNED BY DENTIST)}. AS A RESULT, THE DENTAL ADJUSTMENT/VOID FORMS 209 (EPSDT) & 210 (ADULT), BLOCK 15 HAVE BEEN REVISED (10/04) IN ORDER TO CAPTURE THIS INFORMATION (WHEN REPORTED). EFFECTIVE ON OCTOBER 1, 2004, PROVIDERS MUST BEGIN USING THE REVISED ADJUSTMENT/VOID FORMS WITH REVISION DATE 10/04. THE REVISED FORMS AND INSTRUCTIONS CAN BE DOWNLOADED FROM THE FOLLOWING WEBSITE: HTTP://WWW.LAMEDICAID.COM OR HARDCOPY FORMS CAN BE OBTAINED BY CONTACTING UNISYS PROVIDER RELATIONS AT (800) 473-2783 OR (225)924-5040. UNISYS WILL ACCEPT ONLY THE CURRENT FORMS 209 AND 210 THROUGH SEPTEMBER 30, 2004; AND ONLY THE REVISED FORMS (WITH THE ISSUE DATE OF 10/04) EFFECTIVE OCTOBER 1, 2004. NON-COMPLIANT FORMS WILL BE RETURNED TO THE PROVIDER. SHOULD YOU HAVE ANY QUESTIONS, YOU MAY CONTACT UNISYS PROVIDER RELATIONS AT THE NUMBERS LISTED ABOVE. 

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ATTENTION REHABILITATION PROVIDERS

THE BUREAU OF HEALTH SERVICES FINANCING ANNOUNCES THAT EFFECTIVE OCTOBER 1, 2004, REHABILITATION CENTERS WILL BE ALLOWED TO PROVIDE SPEECH, OCCUPATIONAL, AND PHYSICAL THERAPY SERVICES IN THE HOMES OF RECIPIENTS WITH PRIOR APPROVAL FROM THE UNISYS PRIOR AUTHORIZATION UNIT. A RECIPIENT'S PLACE OF RESIDENCE, FOR THESE SERVICES, DOES NOT INCLUDE A NURSING HOME. 

REQUEST FOR SERVICES SHOULD BE SUBMITTED ON UNISYS FORM 101. SERVICES SHOULD BE BILLED WITH UNISYS FORM 102. THE PLACE OF SERVICE FOR HOME MUST BE INDICATED ON THE PA REQUEST AND ON THE CLAIM.