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Bulletins & Payment Policy Notifications

See the bulletins below to stay up-to-date on news, policy changes, and other issues important to your practice.

 

Bulletins

Update for Emergency Department (ED) Facility Evaluation and Management (E/M)
Coding Reimbursement Policy (PDF 61.89 KB) - 4.4.2018

Pregnant Members Have Up to Two New Patient Visits per Pregnancy (PDF 37.11 KB) - 9.13.2017

Claim Process Updated for Multiple Gestation Deliveries (PDF 41.88 KB) - 9.13.2017

Documentation Not Required for Obstetric Ultrasounds When Billed with Documented Diagnosis Codes (PDF 37.96 KB) - 9.13.2017

Coordination of Benefits (COB) 30-day Extension Requests (PDF 43.78 KB) - 3.7.2017

Breast Cancer (BRCA) Gene Testing Prior Authorization (PDF 42.79 KB) - 10.1.2016  

Urgent* Private TPL and Urgent* Medicare Advantage Plan Update Requests (DOCX 41.62 KB) - 8.15.2016

 

Louisiana Department of Health - Informational Bulletins

View current Informational Bulletins published by the Louisiana Department of Health.

 

Claims Processing Bulletins & Notices

Healthy Lousiana Billing for Hospital Services Revised May 2017 (PDF 189.69 KB) - 5.5.2017 

Healthy Louisiana Billing for Hospital Services 2016 (PDF 219.75 KB) - 12.22.2016 

Healthy Lousiana Billing for Hospital Services 2017 (PDF 189.69 KB) - 1/17/2017 

Healthy Louisiana Billing for Hospital Services 2016 (PDF 219.75 KB) - 12/22/2016 

Global Maternity Procedure Codes for Claims Billed to Medicaid as Secondary Payer (PDF 39.04 KB) 11/7/2016

Pediatric Day Health Care Program (PDHC) Place of Service Code Notice - Effective 10-1-2016 (PDF 146.82 KB)

New Requirements for Claim Submission and Appeals Filing Deadlines (PDF 54.96 KB) - 9/2/2016

Non-Emergency Ambulance Claim Voids and Resubmissions (PDF 217.14 KB) - 5/13/2016

Revenue Code 270 Outpatient Reimbursement Notice (PDF 105.71 KB) - 5/2/2016

Don’t Risk Unnecessary Claim Denials; EPSDT Claim Submission Update (PDF 34.34 KB) - 3/28/16

Provider Taxonomy Claims Processing Edit Suspension Notice (PDF 34.07 KB) - 3/25/16

Emergency Ambulance Claim Voids and Resubmissions (PDF 36.99 KB) - 3/2016

Enhanced HIPAA Claim Edits Planned for March 2015 (PDF 173.48 KB)

Submit Claims for Dates of Service before Feb. 1 by July 31, 2015 (PDF 24.19 KB)

URGENT ALERT: Certain Checks to Be Reissued This Week (PDF 34.68 KB)

PET Scan Approval Requests and Claims Processing (PDF 138.45 KB)

Enhanced HIPAA Edits to be applied to Claim Submissions

UnitedHealthcare Sequestration Implementation (PDF 93.07 KB)

Claims Issue Impacting All Facilities Serving UHC Community Plan Membership (Healthy Louisiana) (PDF 19.72 KB) - March 2012

Continuity of Care for Non-participating Providers (PDF 37.26 KB) - February 2012

Prohibition of Claims Payment Beyond the Borders of the U.S. (PDF 41.21 KB) - Jan. 17, 2012

 

Payment Policy Notifications

Reimbursement Policy Updates (PDF 90.82 KB) - 6.6.2018

Update to National Drug Code (NDC) Policy: Hospital Outpatient Facility Drug Claims (PDF 777.74 KB) - 5.25.2018

Important Reimbursement Reminder for Duplicate or Repeat Services of Global Test Only Codes (PDF 745.2 KB) - 5.4.2018

Drug Testing Reimbursement Policy FAQs (PDF 53.34 KB) - 4.19.2018

Understanding Our Supply Reimbursement Policy (PDF 740.87 KB) - 4.19.2018

Reimbursement Change for Image Guidance Code 77014 (PDF 740.33 KB)  - 3.9.2018

Revision to Laboratory Services Reimbursement Policy (PDF 750.09 KB) - 2.28.2018

Reimbursement Notice for Multiple Procedure Reduction Codes (PDF 762.75 KB) - 1.31.2018

Important Reimbursement Change to Ambulance Reimbursement Policy (PDF 747.29 KB) - 1.26.2018

New Observation Services Facility Policy - Effective May 1, 2018 (PDF 743.75 KB) - 1.26.2018 

Policy Reminder: Reimbursement for Laboratory Claims (PDF 769.75 KB) - 1.5.2018

Revenue Codes Requiring Procedure Codes Reimbursement Policy Clarification for Care Providers at Facilities and Hospitals (PDF 66 KB) - Date Posted 11.29.2017 

Reimbursement Change for Image Guidance Code 77014 (PDF 66 KB) - Date Posted 11.29.2017

Ambulance Reimbursement Policy Coding Guidelines Reminder and Policy Changes for 2018 (PDF 57.68 KB) - Date Posted 10.26.2017

New Add-On Codes Facility Policy - Effective Feb. 1, 2018 (PDF 54.38 KB) - Date Posted 10.20.2017 

Drug Testing Reimbursement Policy Update - Effective Jan. 1, 2018 (PDF 68.64 KB) - Date Posted 10.5.2017

National Drug Code Requirements for UnitedHealthcare Community Plan Professional Claims Frequently Asked Questions (PDF 140.38 KB) - Date Posted 8.22.2017

Reimbursement Change for Prolonged Services Policy (PDF 67.01 KB) - Date Posted 8.18.2017

Claim Reprocessing for Rebundling Code 96160 (PDF 48.51 KB) - Date Posted 7.27.2017

Revision to the Intrauterine Device (IUD) Supply Policy (PDF 52.8 KB) - Date Posted 7.12.2017

UnitedHealthcare Community Plan Bilateral Procedures and Maximum Frequency Per Day Policies – Effective Nov. 11, 2017 (PDF 49.38 KB) - Date Posted 6.28.2017

Two Place-of-Service (POS) Codes Added to Facility POS Code List in Two Policies (PDF 54.97 KB) - Date Posted 6.23.2017

New Drug Testing Reimbursement Policy Effective Sept. 1, 2017 (PDF 120.5 KB) - Date Posted 5.31.2017

UnitedHealthcare Community Plan Medicare Claims Processing System Is Being Upgraded – Effective May 20, 2017 (PDF 39.84 KB) - Date Posted 4.9.2017

Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policy – Acupuncturist Update (PDF 216.94 KB) - Date Posted 4.07.2017

Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policy – Acupuncturist Update (PDF 216.66 KB) - Date Posted 3.31.2017

Retirement of Moderate Sedation and Physical Medicine and Rehabilitation: Supervised Modalities Policies, and Changes to Procedure to Modifier and IMRT Policies - Effective May and June 2017 (PDF 202.22 KB) - Date Posted 3.2.2017

New National Drug Code Requirement Policy – Effective May 1, 2017 (PDF 48.38 KB)  - Date Posted 12.21.2016

Coding Reminder: How to Report Multiple Surgeons for One Operative Session (PDF 737.06 KB) - Date Posted 10.27.2016

Policy Change for the Multiple Procedure Payment Reduction of Diagnostic Imaging Services - Effective Jan. 1, 2017 (PDF 732.87 KB) - Date Posted 10.27.2016

Revision to Maximum Frequency per Day and Bilateral Procedures Policies for Procedure Codes with Bilateral Surgery Indicator of “2” - Effective Feb. 12, 2017  (PDF 110.97 KB)- Date Posted 10.27.2016

Revision to Lupron Policy-Effective January 1, 2017 (PDF 203.22 KB)

New Facility Reimbursement Policy-Appropriate Patient Status for Type of Bill Policy-Effective December 1, 2016 (PDF 180.99 KB) - Date Posted 8.11.2016

Implementation of the new Clinical Laboratory Improvement Amendments Identification Requirements Policy and the Replacement Codes Policy-Effective August 1 and November 1, 2016. Changes to the Non-Covered Codes, Ambulance, and Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policies-Effective in November and December 2016 (PDF 202.15 KB) - Date Posted - 7.29.2016

New Policy-Evaluation and Management Reimbursement Policy (PDF 123.17 KB)

Phase Two Implementation Delay for Supply Reimbursement Policy (PDF 139.5 KB)

Changes to the CCI Editing, DME, Incontinence Supply, Lab Services, and T Status Codes Policies -Effective August 20, 2016 and Implementation of the new Consultation Services Policy-Effective September 1, 2016 (PDF 282.07 KB)

Facility Billing Policy Update Reporting an ICD-10 Manifestation Code as a Primary/Principal Diagnosis - Effective July 1, 2016 (PDF 130.9 KB)

New Intensity-Modulated Radiation Therapy (IMRT) Reimbursement Policy - Effective July 1, 2016 (PDF 122.63 KB)

Changes to the Obstetrical Services and Supply Policies - Effective May 21, 2016 and Changes to the Inappropriate Primary Diagnosis Codes Policy and Implementation of the New Diabetic Testing Strips and Lancets Policy - Effective June 1, 2016 (PDF 204.94 KB)

REVISED: Adjunct Professional Services Policy - Frequently Asked Questions (PDF 394.63 KB)

Adjunct Professional Services Policy-Frequently Asked Questions (PDF 394.61 KB)

Claims Processing Change for Eight Professional Reimbursement Policies - Effective May 21, 2016 (PDF 145.71 KB)

New Place of Service (POS) 19 and Revision to POS 22-Effective January 1, 2016 and Telemedicine Policy Changes-Effective February 13, 2016 (PDF 177.42 KB)

Reporting Obstetrical Procedure Codes with Date Spans (PDF 140.03 KB)

Revision to Time Span Codes Policy - Effective Fourth Quarter 2015 (PDF 120.08 KB)

Reimbursement and Drug Policy Update for ICD-10 (PDF 183.43 KB)

2015 Quarter 3 & 4 Updates: Subsequent Revision Delay for the Radiology Multiple Imaging Reduction and Multiple Procedure Policies (PDF 136.23 KB)

Procedure to Place of Service and Laboratory Services Reimbursement Policy Updates-Effective August 22, 2015 (PDF 191.37 KB)

Additional Changes to Existing Reimbursement Policies-Effective May 16 & 17, 2015 and Reminder Notice for Vaccines for Children Policy (PDF 206.2 KB)

Reimbursement Policy Clarification for the Maximum Frequency Per Day Policy and Revision Delay for the Radiology Multiple Imaging Reduction and Multiple Procedure Policies (PDF 139.15 KB)

Provider Notification for November Payment Policy Updates/Changes - Nov. 1, 2012 (PDF 205.73 KB)

 

Fee Schedules 

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