2010 Informational Letters


Published Informational Letters

Letter# Description Issue Date Effective Date

974

Enforcement Provision Related to Excluded Providers

12/15/2010

2/01/2011

973

Date Span Billing Examples

12/15/2010

12/01/2010

972

Program Integrity Provider Self-Audit

12/15/2010

12/01/2010

971

Iowa Medicaid Pharmacy Program Changes

12/06/2010

1/01/2010

970

Coverage of Non-Drug Products through Pharmacy Point of Sale (POS)

12/06/2010

1/01/2010

969

Nursing Facility and Non-Emergency Medical Transportation (NEMT)

11/23/2010

Immediately

968

Nursing Facility Enhanced Medicaid Payment Report 

11/23/2010

Immediately

967

Prism Code V2715; Policy Change for Add-on Codes; Billing for High Power Lenses; Change in Repair Codes; Billing for Contact Lenses

11/15/2010

12/01/2010

966

Duplicate Claim Submissions

11/15/2010

Immediately

965

Consumer Choices Option Rule Changes

11/08/2010

11/01/2010

964

Billing Discarded Drugs and Biologicals

11/10/2010

12/01/2010

963

Revisions to the State Maximum Allowable Cost (State MAC) Program for Multi-Source Prescription Drugs

11/09/2010

12/06/2010

962

Informational and General Letters-Electronic Format

10/25/2010

12/01/2010

961

Iowa Medicaid Member Services Disease Management and Maternity Management Program

10/29/2010

7/01/2010

960

Retroactive Eligibility- High Technology Radiology Prior Authorizations

10/26/2010

Immediately

959

Nursing Facility Quality Assurance Assessment

10/19/2010

Immediately

958

Non-Emergency Medical Transportation (NEMT) Claims

10/19/2010

10/01/2010

957

Nursing Facilities and Non-Emergency Medical Transportation

10/20/2010

10/01/2010

956

Billing Multiple Units

10/18/2010

11/01/2010

955

TCM - Properly Declaring Units of Service for a Given Date

10/18/2010

12/01/2010

954

Minimum Data Set (MDS) 3.0, Section "Q"

9/29/2010

10/01/2010

953

Consumer Directed Attendant Care (CDAC) Rate Restoration 7/1/10

10/08/2010

7/01/2010

952

Medical Social Services, Targeted Case Management, Case Management and DHS Service for Medicaid Members Receiving Home and Community Based Services Waiver

10/06/2010

10/06/2010

951

Prior Authorization Review Process for HCBS Waiver Services

10/01/2010

10/01/2010

950

Non-Emergency Medical Transportation (NEMT) Services

10/01/2010

10/01/2010

949

Annual Update of Hospice Rates (FFY 2011)

10/01/2010

10/01/2010

948

Flu Vaccines for Children Administered by Pharmacies

10/01/2010

11/01/2010

947

Limited Emergent Hospital Coverage for IowaCare Members

10/01/2010

10/01/2010

946

Cost of Room and Board and Work services Contracts

9/27/2010

9/27/2010

945

Oxygen - Coverage for Small Children, Criteria in Nursing Homes and
Documentation Submitted with Claims
Oral Nutritional Products in Nursing Homes Clarification
Addition of “RB” Modifier for Like Replacement Parts
Rent to Purchase Clarification

9/24/2010

10/01/2010

944

Properly Declaring Units of Service for a Given Date

10/18/2010

12/01/2010

943

Iowa Medicaid Pharmacy Program Changes

9/22/2010

10/18/2010

942

Remedial Clinical Best Practices Quality Initiative 

9/22/2010

10/01/2010

941

Implementation of National Correct Coding Initiative (NCCI) and Compliance with CPT, AMA, and National Coding Guidelines

9/13/2010

10/01/2010

940

Implementation of Local Coverage Determinations (LCD) and Medicare Medically Unlikely Edits (MUE) Editing

9/16/2010

10/08/2010

939

Prior Authorization of Selected Waiver Services

9/16/2010

10/01/2010

938

Feedback Requested for Health IT Planning

9/07/2010

Immediately

937

Billing for Dentures

9/03/2010

Immediately

936

Medicaid Incentive Payment Program Survey

9/01/2010

Now through 10/01/2010

935

2010 Provider Quality Management Self-Assessment

9/01/2010

9/01/2010

934

Rates Restored for Individual CDAC Services

8/23/2010

7/01/2010

933

OB Billing Guidelines for Correct Coding Initiative

8/23/2010

Claims Received on or after 10/1/10

932

Independent Audits of DSH Payment Programs

8/10/2010

8/10/2010

931

Electronic Provider Payments

8/31/2010

9/20/2010

930

Medicaid Program Changes -- 2.5% Reduction Continues for SFY 2011

8/05/2010

7/01/2010

929

Prior Authorization of Selected Waiver Services - Providers

8/02/2010

9/02/2010

928

Prior Authorization of Selected Waiver Services

8/02/2010

9/01/2010

927

110% Average Allowable Cost

7/26/2010

Varies

926

Medicaid Billing Remittance Form 470-3816 

7/26/2010

7/26/2010

925

Iowa Medicaid Credit Balance 

7/19/2010

7/01/2010

924

Pharmacy Feedback Requested for Health IT Planning

7/19/2010

Immediately

923

Laboratory Feedback Requested for Health IT Planning

7/19/2010

Immediately

922

Long Term Care Feedback Requested for Health IT Planning

7/19/2010

Immediately

921

Nursing Facility Quality Assurance Assessment Calculation Worksheet

7/01/2010

Immediately

920

CDAC Rates Continue

6/30/2010

7/01/2010

919

Feedback Requested for Health IT Planning

6/28/2010

Immediately

918

Reimbursement Reductions Announced Previously Continue

7/02/2010

7/01/2010

917

Wound Care

6/23/2010

7/01/2010

916

Medicaid Program Changes - 2.5% Reduction Continues for SFY 2011

6/30/2010

7/01/2010

915

Pharmaceutical Case Management (PCM) and Medicare Coverage

6/28/2010

8/01/2010

914

LT and RT Modifiers V5267-Hearing Aid Supplies/Accessories

6/25/2010

7/01/2010

913

Fee Reductions

6/25/2010

8/01/2010

912

Implementation of National Correct Coding Initiative and Compliance with CPT, AMA, and National Coding Guidelines

6/01/2010

7/01/2010

911

High Technology Prior Authorization-Code Families

6/01/2010

3/01/2010

910

Annual Restraint and Seclusion Attestation Letters

5/25/2010

5/25/2010

909

Electronic Payments and Provider Notification Letters

7/13/2010

8/2010

908

OIG Review and Findings

5/24/2010

5/24/2010

907

Non-emergency Medical Transportation

5/24/2010

5/24/2010

906

Injection Procedures for Pain Management

5/24/2010

7/01/2010

905

Hospice Impact Regarding Legislation Affecting Nursing Facility Rates

5/13/2010

Varies

904

Exclusion from Participation in Federal Health Care Programs

4/30/2010

4/30/2010

903

Iowa Medicaid Pharmacy Program Changes

4/30/2010

5/24/2010

902

Medicaid Incentive Payment Program Survey

4/30/2010

through 5/20/2010

901

Implementation of APC Grouper Version 11.0

4/28/2010

1/01/2010

900

Annual Provider Training 2010

4/26/2010

4/26/2010

899

Enrollment in the Iowa Plan for Behavioral Health

4/26/2010

7/01/2010

898

Legislation Impacting Nursing Facility Rates

4/20/2010

Varies

897

Equipment Rental

4/23/2010

4/01/2010

896

Electronic Payment and Informational Letters

4/15/2010

7/01/2010

895

Medicaid Incentive Payment Program Survey

4/09/2010

through 4/16/2010

894

Auto-Medicaid-submission of certain Medicare denied claims

4/09/2010

4/05/2010

893

Equipment Rental-Use of the "SC" Modifier for Nutritional Products and Wheelchair Repairs in Nursing Homes
Replaced by IL 1829-MC-FFS

4/01/2010

Upon Receipt

892

Clarification on FQHQ - Use of T1015 Encounter Code and MediPASS referral requirements

3/30/2010

3/30/2010

891

5% Reduction: New Rule Change

3/25/2010

12/01/2009

890

Electronic Remittance Advice

3/15/2010

3/18/2010

889

Iowa Medicaid Pharmacy Program Changes

2/25/2010

2/05/2010

888

Consumer Choices Option (CCO) Update

2/19/2010

2/19/2010

887

April 2010 Residential Care Facility Personal Needs Allowance Decrease

3/10/2010

4/01/2010

886

Case Management 2.5% Rate Reduction

3/01/2010

Varies

885

RSP and Standardized Measurement Tool

2/22/2010

3/22/2010

884

SC Modifier
Replaced by IL 1829-MC-FFS

2/22/1010

Upon Receipt

883

Change in Reimbursement for Holding a Bed for a Hospitalized Resident

2/17/2010

2/17/2010

882

Modifier and Payment Policy Updates

3/10/2010

2/01/2010

881

Rate of Reimbursement

2/09/2010

Varies

880

Feedback requested for IT Health Planning

1/30/2010

Immediately

879

Clarification on FQHC and RHC Billing – Use of T1015 Encounter Code

3/15/2010

3/15/2010

878

Repayment Plan Requests

1/26/2010

1/26/2010

877

Third Notice Regarding Changes to Remittance Advice, Payment and Informational Letters

1/27/2010

Varies

876

High Technology Radiology Prior Authorizations

1/28/2010

3/01/2010

875

Implementation of Correct Coding Initiative and Compliance with CPT, AMA, and National Coding Guidelines Retrospective and Prospective Review of Claims

1/15/2010

2/01/2010

874

New FAX Number for Remedial Progress Notes and Remedial Progress Notes Re-evaluation Request/Supplemental Documentation

1/15/2010

2/01/2010