RA Messages for December 29, 2009
PROVIDERS, PLEASE NOTE!!!
If you are unsure
about the coverage of a drug product, please contact the PBM help desk
THE FOLLOWING CHANGES TO APPENDIX A
ACETIC ACID/ALUMINUM ACETATE
OFF LMAC 12/17/2009
Detailed LMAC and FUL
changes are posted on
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
PROVIDERS OF CHILDHOOD IMMUNIZATIONS
vaccine for the booster dose of children aged 15 months through 4 years
for the Haemophilus influenzae type b (Hib) immunization series is
available from the Vaccines for Children (VFC) Program. The American
Medical Association (AMA) has released guidelines for the use of the
Current Procedural Terminology (CPT) procedure code 90648 for reporting
the use of this Hib booster vaccine for the booster (final) dose of the
Hib immunization series (see CPT Assistant September 2009). Louisiana
Medicaid follows this guidance from the AMA and providers of childhood
vaccines should use CPT code 90648 for reporting this vaccine. If
nationally approved changes occur to CPT codes at a future date,
providers are to follow the most accurate coding available for covered
services, unless otherwise directed.
Medicaid will reimburse providers for the administration only of the
vaccine as the vaccine is available from the Louisiana VFC program at no
charge to VFC enrolled providers. Providers should contact the Unisys
Provider Relations unit at (800) 473-2783 or (225) 924-5040 with billing
policy questions. Questions related to this vaccine including its
availability should be directed to the Louisiana Office of Public
Health-Immunization Program at (504) 838-5300.
Nursing Home Case-Mix Rate Training Workshop is scheduled for January
25, 2010 from 1:00 p.m.- 4:30 p.m. at the Department of Environmental
Quality, Galvez Building, Oliver Pollock Conference Room C111, 602 N.
Fifth Street, Baton Rouge, LA 70802.
This program has been designed to provide nursing facility personnel and
consultants an understanding of the Louisiana case-mix rate methodology,
case-mix calculations, fair rental value bed-buy back, private room
conversions, and the use of cost report data.
The training is appropriate for Cost Report Preparers, Accountants
(including Home Office Staff), CFO's, Controllers, Office Managers, and
Others involved in Case-Mix Rate Reviews. 4 CPE credits: Specialized
Knowledge & Applications. Submit registration by January 18, 2010. To
download the registration form, go to http://www.dhh.la.gov/offices/events.asp?ID=111&detail=7910
or contact Myers & Stauffer LC @ 1-800-374-6858.
MULTI-SYSTEMIC THERAPY (MST) PROVIDERS
may now view the current MST Provider Manual on the Medicaid website,
LAMedicaid website now has a "Dental Providers" link on the left of the
homepage. This link provides information about the Medicaid Dental
programs and services available to Medicaid dental providers. The
website can be accessed at www.lamedicaid.com. Questions about the
LAMedicaid website may be directed to Unisys Provider Relations at (800)
473-2783 or (225) 924-5040.
December 1, 2009, Ambulatory Surgery is exempt from the 24 hour rule in
which outpatient services exceeding 24 hours in duration are deemed
inpatient. Ambulatory surgery (Revenue Code 490) and the other revenue
codes associated with the surgery may now be billed as outpatient
regardless of the duration of the outpatient stay.
Any questions should be directed to Provider Relations.