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
Should you have any questions
regarding any of the following messages, please contact Molina Medicaid
Solutions at (800) 473-2783 or (225) 924-5040.
2019 Allowed Procedures for Assistant Surgeon and Assistant at Surgery Providers
Louisiana Medicaid has published the 2019 fee for service list of allowed procedures for assistant surgeon and assistant at surgery providers. The list titled,
“2019 Assistant Surgeon and Assistant at Surgery List of Covered Procedures” has been posted to the LA Medicaid website
(www.lamedicaid.com) under the ClaimCheck icon.
The changes are based on updates made by the Change Healthcare to their ‘ClaimCheck’ product. Change Healthcare uses the American College of Surgeons as its primary source for determining assistant surgery designations.
This list does not ensure payment but provides a comprehensive list of codes that may be allowed when billed by an assistant surgeon or by an assistant at surgery.
For questions related to this information as it pertains to fee-for-service Medicaid claims processing, please contact DXC Technology Provider Services at (800) 473-2783 or (225) 924-5040.
Please contact the appropriate Managed Care Organization with any questions concerning their 2019 HCPCS updates.