Effective beginning dates of service January 1, 2012, and thereafter, Medicaid will adopt the following policy on qualitative drug screening:
The following drug screens will be limited to one specimen every seven days per recipient, per provider (providers within a group are considered a single provider), and may not be billed in any combination: 80100, 80101, 80102, and 80104.
After four years of transition, the Alabama Medicaid Agency is phasing out the acceptance of the old Medicaid ID number for claims processing, effective January 17, 2011. Medicaid will DENY any claims received on or after January 17, 2011, that are submitted with the old Medicaid ID number. All new Medicaid ID numbers issued after the conversion also begin with a “5”. The old Medicaid ID number begins with “000”.
Please verify the Medicaid ID number for Medicaid recipients at the time of service. If the Medicaid ID number
Due to recent provider inquiries regarding incorrect denials of CPT codes billed with modifier 59, Cahaba ran a report to identify all claims denied as duplicates with the use of modifier 59. The report is being researched and adjustments will be made to incorrectly denied claims using an automated system. Until the claims have all been adjusted, our Clerical Error Reopening lines will not adjust claims denied as a duplicate appended with modifier 59 to avoid creating overpayments.
Cahaba Government Benefit Administrators®, LLC -MAC for Jurisdiction 10, which includes Alabama, Georgia and Tennessee
Modifier 59 is an NCCI-associated modifier that is often used incorrectly. This modifier should be used to identify procedures/services that are not normally reported together, but are appropriate under the circumstances.