RA Messages for February 09, 2009
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 note the
following changes to appendix A
Drug Dose Strgth
off MAC 10/18/08
Carbamazepine Oral Susp 100mg/5ml
Tab Susp 0.125mg
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
ATTENTION LTC PROVIDERS
When entering the Number of Days in the
Value Code Fields 39, 40 or 41 of hard copy/paper UB claim forms, you
MUST correctly follow the billing instructions which state: "Enter the
appropriate Value Code in the "Code" portion of the field and the Number
of Days in the "Dollar" portion of the "Amount" section of the field.
Enter "00" in the "Cents" portion of the "Amount" section of the field."
Failure to enter "00" in the "Cents" portion of the field OR entering
the number of days in the "Cents" portion of the field will cause the
claim to deny. Additionally, these same instructions must be followed
when submitting hard copy Medicare Crossover claims that do not cross
automatically from the Medicare carrier. Failure to enter co-insurance
days on Medicare crossovers when appropriate will result in claims
denials for Code 087. Please make any needed changes to your software
and/or procedures to ensure that this information is entered correctly
on all paper claims for Medicaid.
Contact Unisys Provider Relations at (800)473-2783 or (225)924-5040 if
you have questions concerning these instructions.
PROFESSIONAL SERVICES PROVIDERS
Effective with date of service July 1,
2008, Louisiana Medicaid will reimburse for digital mammography
services, currently HCPCS codes G0202 (Screening mammography, producing
direct digital image, bilateral, all views), G0204 (Diagnostic
mammography, producing direct digital image, bilateral, all views), and
G0206 (Diagnostic mammography, producing direct digital image,
unilateral, all views).
Providers should perform the most clinically appropriate method (film or
digital) specific to the recipient. One screening mammography is allowed
(either film OR digital) per female recipient aged 40-99, per calendar