2011 Uniform Percentage Payment Schedule
2010-2011 Seasonal Influenza
New Information Jan. 1, 2011: The Centers for Medicare and Medicaid Services (CMS) has made changes to the codes required for reporting specific Influenza vaccines for MEDICARE eligible patients. The 90658 will not be accepted on and after Jan. 1, 2011. Q codes on the following document are to be reported as indicated by the type of vaccine. CMS MLN Matters MM7234
CMS website with additional information: CMS MLN Matters SE1031.
2010-2011 Seasonal Influenza Memo
Influenza Vaccine Administration Record, LHDO-1 (Rev. 1/1/11)
Influenza Vaccine Administration Record, Spanish (Rev. 1/1/11)
Influenza and Pneumonia Rates (Rev. 1/1/11)
NV Codes for Vaccines
Vaccine Information Sheets (VIS):
MMWR Prevention and Control of Influenza with Vaccines
Centers for Disease Control Prevention (CDC) seasonal flu website
Medicaid and Prescribing Providers
In order to better monitor the prescriptions and the care of Medicaid members, the Kentucky Department for Medicaid Services (DMS) will require all prescribing providers to enroll with DMS as credentialed practitioners. DMS will begin outreach to non-enrolled prescribers to assist with the enrollment process. Effective Sept. 1, 2010, DMS will no longer add non-Medicaid prescribers to our files. Effective Oct. 1, 2010, there will be no reimbursement for prescriptions by non-Medicaid providers, which will result in prescriptions denying. Please notify your patients that if they accept a prescription from a non-Medicaid provider, DMS will not pay for the prescription.
If you have any questions or need assistance in completing the enrollment documentation, please contact the Provider Services Branch at (877)838-5085 Monday-Friday 10 a.m. to 4:30 p.m.
The Patient Encounter Form (PEF) has been revised to include W0211 Food Package Change/Counseling.
The health professional may code W0211 during a face to face encounter for a food package change and any necessary counseling. The counseling may include the following topics:
- formulas tried and problems encountered;
- transition guidelines for formula;
- choosing the correct nipple; and/or
- proper mixing instructions.
Both the food package and the counseling must be documented in the medical record.
If information is provided to a participant, and the encounter is not face to face, a W0211 cannot be coded. This is only coded on the timesheet to 804-129.
If you have any questions, please contact Nicole Nicholas at (502) 564-3827, ext. 3856.