Magnolia Health Plan

Denials for CPT Codes 75572 – 75574

CPT codes 75572-75574 have been opened for reimbursement effectivie 1/1/2010. Claims billed with these codes which denied for Edit 0439 – PROCEDURE NOT A BENEFIT FOR DATE OF SERVICE will be reprocessed for dates of service 1/1/2010 – 8/11/2011. The mass adjustments will begin the week of 02/13/2012. If you have any questions, please contact your provider representative or the Division of Medicaid.

Vaccines for Children Update

The Division of Medicaid (DOM) claims processing procedures were recently modified to be in compliance with the 2009 Code Update AMA change in regards to the billing rules for immunization codes 90471 and 90473. The AMA ruling indicated only one or the other code can be billed on a single date of service. The recent NCCI mutually exclusive ruling also mandates certain codes cannot be billed together by the same physician on the same beneficiary on the same date of service.

Prior Authorization for Plastic Surgeons

Office visits/consults (including follow-up after procedures) with plastic surgeons do not require prior authorization for par providers. Surgery would still require prior authorization as with all other outpatient surgical procedures.

PaySpan Health Training Webinars

Wednesday, February 15th, 2012 – 2 p.m. (EST) – https://www2.gotomeeting.com/register/311130498

Wednesday, March 14th, 2012 – 2 p.m. (EST) – https://www2.gotomeeting.com/register/535888730

February is Children’s Dental Health Month

This month, we want to make you more aware of how important dental health is. Beginning good habits at an early age helps children start on a lifetime of healthy teeth and gums. Also, going for regular dental visits.

February is Heart Month

Heart disease, including stroke, is the leading cause of death for men and women in the United States.

You are at higher risk of heart disease if you are:

A woman age 55 or older

Thyroid Awareness Month

January is Thyroid Awareness Month. The thyroid gland is located in the base of the neck. It is important to make sure your thyroid gland is healthy and functioning properly. The thyroid gland is important to the body’s overall well-being. It influences the function of the heart, brain, liver, kidneys, and skin.

National Birth Defects Prevention Month

January is National Birth Defects Prevention Month. The 2012 theme, “And the Beat Goes On……….Looking to the Future for Healthy Hearts”, focuses on congenital heart defects.

Heart defects affect one in every 100 babies.

January is Cervical Health Awareness Month

It’s the start of a new year! To start the year right, women need to contact their health care provider to schedule a Pap test to check for cervical cancer.

The National Cervical Cancer Coalition stresses the importance of screening and prevention during January Cervical Health Awareness Month. Approximately 11,000 American women will learn they have cervical cancer this year. Nearly 4,000 women will die from an advanced form of the disease.

January is National Glaucoma Awareness Month

Glaucoma is an eye disease that can lead to vision loss if not controlled. Glaucoma is controllable with modern treatment. Treatment cannot reverse damage that has already occurred, but it can prevent further vision loss.