Identifying Oil Spill Related Illnesses/Injuries for Medicaid Recipients

Posted On: 7/14/2010 2:53:46 PM | By: Sam Razi

IMPORTANT INFORMATION FOR MEDICAID PROVIDERS

IDENTIFYING OIL-SPILL RELATED ILLNESSES/INJURIES

FOR MEDICAID RECIPIENTS

DHH is implementing claims billing indicators to be used to identify services provided to Louisiana Medicaid recipients when treated for an oil spill-related illness or injury. This information is necessary to track and evaluate health outcomes and costs related to the BP Oil Spill.

Effective immediately, providers are asked to use the following indicators on applicable claims submitted to Louisiana Medicaid for processing and payment:

EDI 837P Transaction for Professional Services - Enter modifier U9 (Disaster Related Service or Illness) with all appropriate procedure codes. This modifier should follow any other modifiers currently required for claims payment.

CMS-1500 Claim Form - Enter modifier U9 (Disaster Related Service or Illness) with all appropriate procedure codes. This modifier should follow any other modifiers currently required for claims payment.

EDI 837I Transaction for Institutional Services - Enter the Condition Code DR (Disaster Related Service or Illness) as the first Condition Code with all appropriate services.

UB-04 Claim Form - Enter the Condition Code DR (Disaster Related Service or Illness) as the first Condition Code with all appropriate services.

Pharmacy POS Transactions - Enter the NCPDP Field Reason for Service Code (Data Element 439-E4) valid value "RE" (Suspected Environmental Risk) with all appropriate services.

Providers should begin immediately using these indicators on claims submitted for Medicaid payment. Please contact Molina Provider Relations at (800) 473-2783 or (225) 924-5040 with any related questions.