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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

How To Submit A Corrected Claim (July 2018) (PDF 56.45 KB) - 07.09.2018

New In 2018! UnitedHealthcare Community Plan Primary Care Professional Incentive Program Notice (PDF 60.01 KB) - 6.29.2018
Louisiana Department of Health Hepatitis C Criteria Revision Notice for April 2018 (PDF 372.64 KB) - 5.17.2018
2018 CPT and HCPCS Claim System Edits (PDF 48.06 KB) - 4.9.2018
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  

 

 

Louisiana Department of Health - Informational Bulletins

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

 

Claims Processing Notices

Healthy Lousiana Billing for Hospital Services - Revised May 2017 (PDF 189.69 KB) - 5.5.2017 
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) - 11.17.2016
Pediatric Day Health Care Program (PDHC) Place of Service Code Notice - Effective Oct. 1, 2016 (PDF 146.82 KB) - 9.27.2016
New Requirements for Claim Submission and Appeals Filing Deadlines (PDF 54.96 KB) - 9.2.2016

 

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

 

Fee Schedules 

View Fee Schedule