RA Messages for January 08, 2008
PHARMACY PROVIDERS, PLEASE
IF YOU ARE UNSURE ABOUT THE COVERAGE OF A DRUG
PRODUCT, PLEASE CONTACT THE PBM HELP DESK AT 1-800-648-0790.
PLEASE FILE ADJUSTMENTS FOR CLAIMS THAT MAY HAVE BEEN INCORRECTLY PAID.
ONLY THOSE PRODUCTS OF THE MANUFACTURERS WHICH PARTICIPATE IN THE
FEDERAL REBATE PROGRAM WILL BE COVERED BY THE MEDICAID PROGRAM.
PARTICIPATION MAY BE VERIFIED IN APPENDIX C, AVAILABLE AT
URGENT: Attention Providers
AND BILLING VENDORS
The Federal statute requiring
the use of the National Drug Code (NDC) on claims for physician
administered drugs effective January 2008 will be implemented in the
Medicaid claims processing system and will result in denial of
non-compliant claims in the near future. The NDC number and the HCPCS
code for drug products will be required on both the 837P and the
CMS-1500 for reimbursable medications. The effective date of the NDC
requirement on system edits has not yet been determined. Providers and
billing vendors are requested to immediately begin updating their
billing systems, complete the necessary changes to information systems,
and update internal policies and procedures to ensure that these
requirements are met. Billing instructions can be found in the 2007
training manuals for Professional Services, KidMed, and RHC/FQHC
Services in the section of information pertaining to the CMS-1500 form.
Providers and billing vendors
must monitor the Louisiana Medicaid website at
remittance advice messages for important information regarding the date
of implementation and further instructions.