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 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 http://www.lamedicaid.com. 

Should you have any questions regarding any of the following messages, please contact Molina Medicaid Solutions at (800) 473-2783 or (225) 924-5040.

ATTENTION OUTPATIENT HOSPITAL AND OUTPATIENT HOSPITAL CLINIC PROVIDERS

Effective for dates of service on or after July 1, 2019, CPT codes 80320-80377 for individual substance(s) or metabolites will no longer be covered on the outpatient hospital services fee schedules. Providers should instead use HCPCS codes G0480 or G0481 or their successors. These changes are to be consistent with Louisiana Medicaid’s newly adopted Definitive Drug Testing Policy.

Attention Providers of Laboratory Services

Effective for dates of service on or after August 1, 2019, Louisiana Medicaid will require all providers to include a valid Clinical Laboratory Improvement Amendments (CLIA) number on all claims submitted for laboratory services. Claims submitted with an absent, incorrect or invalid CLIA number will deny.

For claims submitted using the CMS-1500 form, the CLIA number will be required in block 23. Providers should refer to the CMS 1500 Billing Instructions under the Billing Information link at www.lamedicaid.com, where complete instructions will be provided.

Information regarding this policy change is forthcoming and will be found on www.lamedicaid.com under the Provider Manuals link, within the Professional Services and Independent Laboratory manuals.

Questions regarding this message and fee for service claims should be directed to DXC Technology Provider Relations at (800) 473-2783 or (225) 924-5040. Questions regarding managed care claims should be directed to the appropriate Managed Care Organization.