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.
For information regarding the medication policy and/or criteria associated with this denial, providers
may access the Louisiana Medicaid Preferred Drug List (PDL) / Non-Preferred Drug List at
ATTENTION ALL MANAGED CARE ENTITIES
END-OF-TIME DATE CONVERSION FROM 12/31/2020 TO 12/31/2050
LDH Medicaid and DXC would like to announce that file end-of time dates will be converting from 12/31/2020 to 12/31/2050. DXC will convert end-of-time date on recipient eligibility and TPL data. DXC is working with Maximus to test these changes in their processes, including the 834 file process. DXC will alter the TPL file to use an end-of-time date of 12/31/2050 and will send test files to the plans. For Provider registry, DXC will convert 12/31/2020 to 12/31/2050 as an end-of-time date and will test with the plans.
If there are any questions regarding this message, please contact DXC Provider Relations at (800) 473-2783.
Recycle of Denied Claims for CPT Code 82962
Louisiana Medicaid has recently updated the fee-for-service (FFS) Clinical Laboratory Improvement Amendments (CLIA) claims processing logic to no longer require modifier QW when submitting Current Procedural Terminology (CPT) code 82962 (Glucose, blood by glucose monitoring device(s)…).
Fee-for-service claims submitted with date of service January 1, 2018 and after with procedure code 82962 that were denied due to requiring modifier QW will be recycled without any action required by providers.
Please contact DXC Technology Provider Relations at (800) 473-2783 or (225) 924-5040 if there are questions related to this matter concerning FFS claims.