DOH Medicaid Update May 2001 Vol.16, No.5

Office of Medicaid Management
DOH Medicaid Update
May 2001 Vol.16, No.5

State of New York
George E. Pataki, Governor

Department of Health
Antonia C. Novello, M.D., M.P.H., Dr. P.H.
Commissioner

Medicaid Update
is a monthly publication of the
New York State Department of Health,
Office of Medicaid Management,
14th Floor, Room 1466,
Corning Tower, Albany,
New York 12237

Table of Contents

NYS Medicaid Covers Stop Smoking Medications
Attention Physicians - Modifier - 62: Two Surgeons
Diabetes and Vision
From the Desk of Dr. Harvey R. Bernard M. D. Medical Director
What Is the Link Between Asthma & Secondhand Smoke?
Attention Pharmacy Providers Serving Nursing Home & Child Care Agencies
Revised Medicaid Fee Schedules

FREE POSTERS!
NEW YORK STATE MEDICAID COVERS STOP SMOKING MEDICATIONS
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The New York State Smokers' Quitline is offering free posters "New York State Medicaid Covers Stop Smoking Medications." The colored posters come in 2 sizes; 11" x 17" and 22" x 28" and are available in English or Spanish.

To order, call the New York State Smokers' Quitline at:
1-866-NYQUITS (1-866-697-8487)

ATTENTION: Physicians
Modifier -62: Two Surgeons
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Clarification of Medicaid billing using modifier -62. When two surgeons (usually of different skills) work together as primary surgeons performing distinct part(s) of a single reportable procedure, add modifier -62 to the procedure code number. One surgeon should file one claim line representing the procedure performed by the two surgeons. Medicaid reimbursement may not exceed 125% of the Maximum State Medical Fee Schedule amount.

Based on prior agreement, the billing surgeon will apportion the total payment in relation to the responsibility and work done. Questions should be directed to the Medicaid Bureau of Medical Review and Payment at 518-474-8161.

Saving Your Patient's Eyesight
Glasses
Diabetes and Vision
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According to the American Diabetes Association, individuals with either Type 1 or Type 2 diabetes are at risk for developing serious eye disease. Diabetic retinopathy affects half of all Americans diagnosed with diabetes and is the leading cause of blindness in American adults. Early detection and treatment can substantially reduce severe vision loss or blindness.

The American Diabetes Association recommends the following to prevent eye problems in people with diabetes:

  • Keep high blood pressure under control (<130/85)
  • Quit smoking
  • Visit an eye care professional at least once a year* for a dilated eye exam which should include a visual acuity test, pupil dilation, ophthalmoscopy, and tonometry

People with diabetes should visit their eye care professional if they experience:

  • blurry vision
  • difficulty reading
  • double vision
  • one or both eyes hurt
  • pressure in an eye
  • spots or floaters
  • changes in peripheral vision

It is also important for patients with diabetes to see an eye care professional every year even if they have no symptoms. The disease may progress without symptoms.

Studies show that people who keep their glucose level as close to normal as possible have less eye disease and a slower onset of the disease. The Medicaid program reimburses for medically necessary care, services, and supplies for the diagnosis and treatment of diabetes.

*Providers must bill the appropriate evaluation and management code for the annual eye exam.

For more information about diabetes and vision, the following websites are available:

The American Diabetes Association
http://www.diabetes.org
The National Eye Institute
http://www.nei.nih.gov

We encourage readers to share these publications with their clinical practitioners. Please contact the Bureau of Program Guidance at (518) 474-9219 with suggestions for articles that would be of interest to you in improving health outcomes for your patients.

FROM THE DESK OF DR. HARVEY R. BERNARD, M.D. MEDICAL DIRECTOR
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Desk

Bronchial asthma, a chronic inflammatory disorder of the airways, is an increasing problem, not only in New York State, but nationwide. As integral partners in the healthcare delivery system in New York, medical practitioners need to address this problem actively.

In 1997, the National Heart, Lung and Blood Institute (NHLBI) published an Expert Panel Report on Asthma. Despite this report, many healthcare professionals are not aware of the advice provided. The following is a summary of the Expert Panel's report:

Components of Asthma Diagnosis and Treatment of Bronchial Asthma
Highlighted by the Expert Panel

  1. Initial Assessment and Monitoring: It is important to diagnose asthma correctly and to help the patients follow a prescribed routine. Patients, especially those with moderate to severe asthma, require a written action plan. Daily peak flow monitoring by the patient is recommended.
  2. Control of Factors Contributing to Severity: These factors include environmental tobacco smoke, air pollution and exposure to allergens. Other factors that contribute to severity include rhinitis and sinusitis, gastroesophogeal reflux, viral respiratory infection and some medications. Health professionals should assess the presence of these factors and assist their patients to find ways to minimize exposure.
  3. Pharmacologic Therapy: A stepwise approach is recommended with type and amount dictated by severity. Long-term control is most effective when therapy is directed toward long-term suppression of the chronic inflammation.
  4. Patient Education of a Partnership: Patient education to promote an active partnership with the health care professional remains the cornerstone of asthma management and should be integrated into every step of clinical asthma care.

For more information on the NHLBI guidelines:
National Guideline Clearinghouse
www.guideline.gov
NYS Medicaid Update
www.health.state.ny.us

Thank you for your assistance in promoting and providing quality healthcare for our Medicaid recipients.

Our Medicaid population may be among the neediest of patients and Medicaid appreciates your assistance in making our recipients healthier. I would like to solicit your input/suggestions on how best to treat and manage this population. Please contact me if you would like to share your ideas.

Harvey R. Bernard, M.D.
New York State Department of Health
Medical Director, Office of Medicaid Management
99 Washington Avenue, Suite 800
Albany, New York, 12210
518-474-8161
hrb01@health.state.ny.us

WHAT IS THE LINK BETWEEN ASTHMA AND SECONDHAND SMOKE?
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Secondhand smoke, also known as Environmental Tobacco Smoke, is a combination of smoke given off by a burning cigarette, cigar or pipe and the smoke exhaled by a smoker. This combination contains over 4,000 substances, many of which are known to cause cancer and many of which are strong irritants.

How Does Secondhand Smoke Affect People?

  • In people with asthma, secondhand smoke is believed to be an irritant to the chronically inflamed asthmatic airways and not an allergic reaction. The EPA estimates that between 200,000 and 1,000,000 asthmatic children have their condition made worse by exposure to secondhand smoke.
  • In children who do not have asthma, secondhand smoke is a risk factor for the development of new cases of asthma.
  • Secondhand smoke also plays a role in the development of other health issues. It can increase the risk of pneumonia and bronchitis, ear infections in children, lung cancer and may affect the cardiovascular system.

What Can We Do?

Start by advising your patient of the following:

  • Don't smoke in your home or car and do not permit others to do so
  • Don't smoke in the presence of people with asthma
  • Don't smoke in the presence of children
  • Don't allow babysitters or others who work in your home to smoke in the house or near your children
  • Ask grandparents not to smoke in the presence of their grandchildren

Thank you for your continued assistance in helping NYS Medicaid recipients become healthier. If your patients need further assistance in smoking cessation, a toll-free Smokers' Quitline is available by calling 1-866-NYQUITS (1-866-697-8487).

Reminder: NYS Medicaid covers both prescription and non-prescription smoking cessation agents. For more information on Medicaid's smoking cessation coverage policy, contact the Bureau of Program Guidance at 518-474-9219. Medicaid also pays for medically necessary care, services and supplies for the diagnosis and treatment of asthma.

References: CDC National Center for Chronic Disease Prevention and Health Promotion. Secondhand Smoke in Your Home Tip Sheet. November 2, 2000.

American Lung Association Fact Sheet. Asthma in Children. April 1999. United States Environmental Protection Agency. Secondhand Smoke. EPA-402-F-93-004. July 1993.

ATTENTION PHARMACY PROVIDERS SERVING NURSING HOME AND CHILD CARE AGENCIES
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The following listing includes all drugs that have been determined not to be included within the drug cost components of Article 28 Nursing Facility Rates and Child (Foster) Care Agency Rates. Claims for drugs on this list may be billed directly to Medicaid by an MMIS enrolled pharmacy.

Questions regarding the addition of drugs to the Nursing Home Carveout List may be addressed to Health System Management at 518-474-1988. Questions regarding the Child (Foster) Care Carveout List may be addressed to Gail Charlson at 518-474-6398. Questions regarding submission of pharmacy claims may be addressed to Computer Sciences Corporation at 1-800-522-5535.

If a product has an end date, it is no longer commercially available using that specific NDC code. If a drug has an "NH" indicator, it is included on the Nursing Home Carveout List. If a drug has an "FC" indicator, it is included on the Child (Foster) Care Carveout List.

NDC CODE NAME OF DRUG NH START END FC START END
00002411204 ZYPREXA 2.5MG TABLET nh 11/6/00   fc 11/6/00  
00002411260 ZYPREXA TAB 2.5MG nh 9/1/97   fc 2/1/99  
00002411504 ZYPREXA 5MG TABLET nh 11/6/00   fc 11/6/00  
00002411560 ZYPREXA TAB 5MG nh 9/1/97   fc 2/1/99  
00002411660 ZYPREXA TAB 7.5MG nh 9/1/97   fc 2/1/99  
00002411704 ZYPREXA TAB 10MG nh 11/6/00   fc 11/6/00  
00002411760 ZYPREXA TAB 10MG nh 9/1/97   fc 2/1/99  
00002441530 ZYPREXA TAB 15MG nh 12/6/99   fc 12/6/99  
00002441533 ZYPREXA TAB 15MG nh 2/22/00   fc 2/22/00  
00002441560 ZYPREXA 15MG TABLET nh 12/15/00   fc 12/15/00  
00002442060 ZYPREXA 20MG TABLET nh 12/18/00   fc 12/18/00  
00002445385 ZYPREXA ZYDIS TAB 5MG nh 9/18/00   fc 9/18/00  
00002445485 ZYPREXA ZYDIS TAB 10MG nh 9/18/00   fc 9/18/00  
00002733501 HUMATROPE INJ 5MG       fc 2/1/99  
00002733516 HUMATROPE INJ 5MG       fc 2/1/99  
00003196401 ZERIT CAP 15MG nh 10/1/96   fc 2/1/99  
00003196501 ZERIT CAP 20MG nh 10/1/96   fc 2/1/99  
00003196601 ZERIT CAP 30MG nh 10/1/96   fc 2/1/99  
00003196701 ZERIT CAP 40MG nh 10/1/96   fc 2/1/99  
00003196801 ZERIT SOL 1MG/ML nh 1/27/97   fc 2/1/99  
00004022001 HIVID TAB 0.375MG nh 7/27/92   fc 2/1/99  
00004022101 HIVID TAB 0.75MG nh 7/27/92   fc 2/1/99  
00004024515 INVIRASE CAP 200MG nh 10/1/96   fc 2/1/99  
00004024648 FORTOVASE CAP 200MG nh 11/17/97   fc 2/1/99  
00004026948 CYTOVENE CAP 250MG nh 12/5/95   fc 2/1/99  
00004027848 CYTOVENE CAP 500MG nh 2/9/98   fc 2/1/99  
00004694003 CYTOVENE INJ 500MG nh 2/26/96   fc 2/1/99  
00006057062 CRIXIVAN 100MG CAP nh 12/19/00   fc 12/19/00  
00006057142 CRIXIVAN CAP 200MG nh 10/1/96   fc 2/1/99  
00006057143 CRIXIVAN CAP 200MG nh 10/1/96   fc 2/1/99  
00006057318 CRIXIVAN 400MG CAPSULE nh 12/1/00   fc 12/1/99  
00006057340 CRIXIVAN CAP 400MG nh 2/12/01   fc 2/12/01  
00006057354 CRIXIVAN CAP 400MG nh 6/2/97   fc 2/1/99  
00006057362 CRIXIVAN CAP 400MG nh 10/1/96   fc 2/1/99  
00006057465 CRIXIVAN CAP 333MG nh 3/1/99   fc 3/1/99  
00006057465 CRIXIVAN 333MG CAPSULE nh 3/1/99   fc 3/1/99  
00009376103 RESCRIPTOR TAB 100MG nh 4/11/97   fc 2/1/99  
00009757601 RESCRIPTOR TAB 200MG nh 10/26/99   fc 10/26/99  
00013260694 GENOTROPIN INJ 1.5MG       fc 2/1/99  
00013261681 GENOTROPIN INJ 5.8MG       fc 2/1/99  
00013261694 GENOTROPIN INJ 5.8MG       fc 2/1/99  
00013262681 GENOTROPIN INJ 5.8MG       fc 2/1/99  
00013262694 GENOTROPIN INJ 5.8MG       fc 2/1/99  
00013264681 GENOTROPIN INJ 13.8MG       fc 2/1/99  
00013264694 GENOTROPIN INJ 13.8MG       fc 2/1/99  
00026064012 GAMIMUNE N INJ 5%       fc 2/1/99 12/31/00
00026064020 GAMIMUNE N INJ 5%       fc 2/1/99 12/31/00
00026064025 GAMIMUNE N INJ 5%       fc 2/1/99 12/31/00
00026064071 GAMIMUNE N INJ 5%       fc 2/1/99 12/31/00
00026064612 GAMIMUNE N INJ 5%       fc 2/1/99  
00026064620 GAMIMUNE N INJ 5%       fc 2/1/99  
00026064624 GAMIMUNE N INJ 5%       fc 2/1/99  
00026064671 GAMIMUNE N INJ 5%       fc 2/1/99  
00026064812 IMMUNE GLOBU INJ 10%       fc 2/1/99  
00026064815 GAMIMUNE N INJ 10%       fc 2/1/99  
00026064820 IMMUNE GLOBU INJ 10%       fc 2/1/99  
00026064824 IMMUNE GLOBU INJ 10%       fc 2/1/99  
00026064871 IMMUNE GLOBU INJ 10%       fc 2/1/99  
00026064912 GAMIMUNE N INJ 10%       fc 2/1/99 12/31/00
00026064920 GAMIMUNE N INJ 10%       fc 2/1/99 12/31/00
00026064924 GAMIMUNE N INJ 10%       fc 2/1/99 12/31/00
00026064971 GAMIMUNE N INJ 10%       fc 2/1/99 12/31/00
00033290348 CYTOVENE INJ 500MG nh 4/15/92 12/31/00 fc 2/1/99 12/31/00
00033291350 CYTOVENE CAP 250MG nh 1/20/95 12/31/00 fc 2/1/99 12/31/00
00053100003 PENTAMIDINE INJ 300MG nh 4/1/95 12/31/00 fc 2/1/99 12/31/00
00053100005 PENTAMIDINE INJ 300MG nh 4/1/95   fc 2/1/99  
00053748601 GAMMAR-P IV INJ 1 GM       fc 2/1/99  
00053748602 GAMMAR-P IV INJ 2.5 GM       fc 2/1/99  
00053748605 GAMMAR-P IV INJ 5 GM       fc 2/1/99  
00053748606 GAMMAR-P IV INJ 5 GM       fc 2/1/99  
00053748610 GAMMAR-P IV INJ 10 GM       fc 2/1/99  
00053749006 GAMMAR IV INJ 5GM HU       fc 2/1/99 12/31/00
00053760501 HUMATE-P INJ 250IU HU nh 7/27/92   fc 2/1/99  
00053760502 HUMATE-P INJ 500IU HU nh 7/27/92   fc 2/1/99  
00053760504 HUMATE-P HU INJ 1000IU nh 7/27/92   fc 2/1/99  
00053765601 MONOCLATE-P INJ 250 AHFU nh 7/27/92   fc 2/1/99  
00053765602 MONOCLATE-P INJ 500 AHFU nh 7/27/92   fc 2/1/99  
00053765604 MONOCLA-P HU INJ 1000IU nh 7/27/92   fc 2/1/99  
00054390558 VIRAMUNE SUS 50MG/5ML nh 10/5/98   fc 2/1/99  
00054464721 VIRAMUNE TAB 200MG nh 10/5/98   fc 2/1/99  
00054464725 VIRAMUNE TAB 200MG nh 10/1/96   fc 2/1/99  
00056047030 SUSTIVA CAP 50MG nh 9/18/98   fc 2/1/99  
00056047330 SUSTIVA CAP 100MG nh 9/18/98   fc 2/1/99  
00056047492 SUSTIVA CAP 200MG nh 9/18/98   fc 2/1/99  
00062030302 PROCRIT INJ 3000U/ML nh 1/1/94 12/31/00 fc 2/1/99 12/31/00
00062030402 PROCRIT INJ 4000U/ML nh 1/1/94 12/31/00 fc 2/1/99 12/31/00
00062031002 PROCRIT INJ 10000/ML nh 1/1/94 12/31/00 fc 2/1/99 12/31/00
00062740003 PROCRIT INJ 4000U/ML nh 1/1/94 12/31/00 fc 2/1/99 12/31/00
00062740103 PROCRIT INJ 10000/ML nh 1/1/94 12/31/00 fc 2/1/99 12/31/00
00062740201 PROCRIT INJ 2000U/ML nh 1/1/94 12/31/00 fc 2/1/99 12/31/00
00062740501 PROCRIT INJ 3000U/ML nh 1/1/94 12/31/00 fc 2/1/99 12/31/00
00070145002 DESMOPRESSIN SPRAY 0.01% nh 1/26/99   fc 2/1/99  
00074194063 NORVIR SOL 80MG/ML nh 10/1/96   fc 2/1/99  
00074395646 KALETRA SOLN 00074 3956 46 nh 9/19/00   fc 9/19/00  
00074395977 KALETRA CAPSULE nh 9/19/00   fc 9/19/00  
00074454801 PENTAMIDINE INJ 300MG nh 6/11/92   fc 2/1/99  
00074454849 PENTAMIDINE INJ 300MG nh 11/20/95   fc 2/1/99  
00074568113 DEPAKENE CAPSULE 250MG nh 3/19/01   fc 3/19/01  
00074568216 DEPAKENE SYRUP 250MG/5ML nh 3/19/01   fc 3/19/01  
00074611413 DEPAKOTE SPR CAP 125MG nh 3/19/01   fc 3/19/01  
00074621213 DEPAKOTE TAB 125MG nh 3/19/01   fc 3/19/01  
00074621413 DEPAKOTE TAB 250MG EC nh 3/19/01   fc 3/19/01  
00074621453 DEPAKOTE TAB 250MG EC nh 3/19/01   fc 3/19/01  
00074621513 DEPAKOTE TAB 500MG EC nh 3/19/01   fc 3/19/01  
00074621553 DEPAKOTE TAB 500MG EC nh 3/19/01   fc 3/19/01  
00074663322 NORVIR CAP 100MG SG nh 6/30/99   fc 6/30/99  
00074712613 DEPAKOTE ER TAB 500MG SR nh 3/19/01   fc 3/19/01  
00074949202 NORVIR CAP 100MG nh 10/1/96   fc 2/1/99  
00074949254 NORVIR CAP 100MG nh 10/1/96 12/31/00 fc 2/1/99 12/31/00
00075001600 DDAVP TAB 0.1MG nh 1/8/96   fc 2/1/99  
00075002600 DDAVP TAB 0.2MG nh 1/8/96   fc 2/1/99  
00075094501 DDAVP INJ 15MCG/ML nh 2/12/96 12/31/00 fc 2/1/99 12/31/00
00075094502 DDAVP INJ 15MCG/ML nh 2/12/96   fc 2/1/99  
00075245001 DDAVP SOL 0.01% nh 7/27/92   fc 2/1/99  
00075245002 DDAVP SOL 0.01% nh 7/27/92   fc 2/1/99  
00075245101 DDAVP INJ 4MCG/ML nh 7/27/92   fc 2/1/99  
00075245153 DDAVP INJ 4MCG/ML nh 7/27/92   fc 2/1/99  
00075245201 DDAVP SOL 0.01% nh 6/23/97   fc 2/1/99  
00075770060 RILUTEK TAB 500MG nh 3/19/01   fc 3/19/01  
00078010901 SANDIMMUNE INJ 50MG/ML nh 8/1/95   fc 2/1/99  
00078011022 SANDIMMUNE SOL 100MG/ML nh 8/1/95   fc 2/1/99  
00078012094 SANDOGLOBULI INJ 1GM       fc 2/1/99  
00078012219 SANDOGLOBULI INJ 3GM       fc 2/1/99  
00078012295 SANDOGLOBULI INJ 3GM       fc 2/1/99  
00078012419 SANDOGLOBULI INJ 6GM       fc 2/1/99 12/31/00
00078012496 SANDOGLOBULI INJ 6GM       fc 2/1/99  
00078012605 CLOZARIL TAB 25MG nh 4/15/92   fc 2/1/99  
00078012606 CLOZARIL TAB 25MG nh 4/15/92   fc 2/1/99  
00078012705 CLOZARIL TAB 100MG nh 4/15/92   fc 2/1/99  
00078012706 CLOZARIL TAB 100MG nh 4/15/92   fc 2/1/99  
00078024015 SANDIMMUNE CAP 25MG nh 8/1/95   fc 2/1/99  
00078024115 SANDIMMUNE CAP 100MG nh 8/1/95   fc 2/1/99  
00078024215 SANDIMMUNE CAP 50 MG nh 8/1/95 12/31/00 fc 2/1/99 12/31/00
00078024419 SANDOGLOBULI INJ IV 12GM       fc 2/1/99 12/31/00
00078024493 SANDOGLOBULI INJ IV 12GM       fc 2/1/99  
00078024615 NEORAL CAP 25 MG nh 2/1/96   fc 2/1/99  
00078024815 NEORAL CAP 100 MG nh 2/1/96   fc 2/1/99  
00078027422 NEORAL SOL 100MG/ML nh 2/1/96   fc 2/1/99  
00081010855 RETROVIR CAP 100MG nh 4/15/92 12/31/00 fc 2/1/99 12/31/00
00081010856 RETROVIR CAP 100MG nh 4/15/92 12/31/00 fc 2/1/99 12/31/00
00081011318 RETROVIR SYP 10MG/ML nh 4/15/92 12/31/00 fc 2/1/99 12/31/00
00087661443 VIDEX POW 100MG nh 10/1/96   fc 2/1/99  
00087661543 VIDEX POW 167MG nh 10/1/96   fc 2/1/99  
00087661643 VIDEX POW 250MG nh 10/1/96   fc 2/1/99  
00087661743 VIDEX POW 375MG nh 10/1/96 12/31/00 fc 2/1/99 12/31/00
00087662443 VIDEX CHW 50MG nh 10/1/96 12/31/00 fc 2/1/99 12/31/00
00087662643 VIDEX CHW 150MG nh 10/1/96 12/31/00 fc 2/1/99 12/31/00
00087662743 VIDEX CHW 100MG nh 10/1/96 12/31/00 fc 2/1/99 12/31/00
00087662843 VIDEX CHW 25MG nh 10/1/96 12/31/00 fc 2/1/99 12/31/00
00087663241 VIDEX POW 2GM nh 10/1/96   fc 2/1/99  
00087663341 VIDEX POW 4GM nh 10/1/96   fc 2/1/99  
00087665001 VIDEX BUFFER CHW 25MG nh 10/1/96   fc 2/1/99  
00087665101 VIDEX BUFFER CHW 50MG nh 10/1/96   fc 2/1/99  
00087665201 VIDEX BUFFER CHW 100MG nh 10/1/96   fc 2/1/99  
00087665301 VIDEX BUFFER CHW 150MG nh 10/1/96   fc 2/1/99  
00088115003 COPAXONE INJ 20MG nh 9/26/00   fc 9/26/00  
00093963316 VALPROIC ACID SYRUP 250MG/5ML nh 3/19/01   fc 3/19/01  
00121067516 VALPROIC ACID SYRUP 250MG/5ML nh 3/19/01   fc 3/19/01  
00161062520 KONYNE-HT INJ500U nh 7/27/92 09/30/00 fc 2/1/99 09/30/00
00161062550 KONYNE-HT INJ500U nh 7/27/92 09/30/00 fc 2/1/99 09/30/00
00161062650 KONYNE 80 INJ 1000IU nh 7/27/92 09/30/00 fc 2/1/99 09/30/00
00161066020 KOATE-HS INJ 250IU HU nh 7/27/92 09/30/00 fc 2/1/99 09/30/00
00161066030 KOATE-HS INJ 500IU HU nh 7/27/92 09/30/00 fc 2/1/99 09/30/00
00161066050 KOATE-HS HU INJ 1000IU nh 7/27/92 09/30/00 fc 2/1/99 09/30/00
00161066420 KOATE-HP INJ 250IU HU nh 7/27/92 09/30/00 fc 2/1/99 09/30/00
00161066430 KOATE-HP INJ 500IU HU nh 7/27/92 09/30/00 fc 2/1/99 09/30/00
00161066450 KOATE-HP HU INJ 1000IU nh 7/27/92 09/30/00 fc 2/1/99 09/30/00
00161066460 KOATE-HP INJ 1500AHFU nh 7/27/92 09/30/00 fc 2/1/99 09/30/00
00169777011 NORDITROPIN INJ CARTRIDGE       fc 10/2/00  
00169777411 NORDITROPIN INJ 4MG       fc 2/1/99  
00169777812 NORDITROPIN INJ 8MG       fc 2/1/99  
00172435960 CLOZAPINE TAB 25MG nh 12/1/97   fc 2/1/99  
00172435970 CLOZAPINE TAB 25MG nh 12/1/97   fc 2/1/99  
00172436060 CLOZAPINE TAB 100MG nh 12/1/97   fc 2/1/99  
00172436070 CLOZAPINE TAB 100MG nh 12/1/97   fc 2/1/99  
00173010793 RETROVIR INJ 10MG/ML nh 8/12/96   fc 2/1/99  
00173010855 RETROVIR CAP 100MG nh 7/9/96   fc 2/1/99  
00173011318 RETROVIR SYP 10MG/ML nh 8/12/96   fc 2/1/99  
00173047001 EPIVIR TAB 150MG nh 10/1/96   fc 2/1/99  
00173047100 EPIVIR SOL 10MG/ML nh 10/1/96   fc 2/1/99  
00173050100 RETROVIR TAB 300MG nh 10/14/96   fc 2/1/99  
00173059500 COMBIVIR TAB nh 5/18/98   fc 2/1/99  
00173066101 ZIAGEN TAB 300MG nh 12/30/98   fc 2/1/99  
00173066200 EPIVIR HBV TAB 100MG nh 12/21/98   fc 2/1/99  
00173066300 EPIVIR HBV SOL 5MG/ML nh 12/21/98   fc 2/1/99  
00173066400 ZIAGEN SOL 20MG/ML nh 12/30/98   fc 2/1/99  
00173067200 AGENERASE CAP 150MG nh 4/26/99   fc 4/26/99  
00173067200 AGENERASE 150MG CAPSULE nh 4/26/99   fc 4/26/99  
00173067900 AGENERASE CAP 50MG nh 4/26/99   fc 4/26/99  
00173068700 AGENERASE SOL 15MG/ML nh 5/5/99   fc 5/5/99  
00173069100 TRIZIVIR TABLET nh 11/16/00   fc 11/16/00  
00182175401 VALPROIC ACID CAP 250MG nh 3/19/01   fc 3/19/01  
00182611540 VALPROIC ACID SYRUP 250MG/5ML nh 3/19/01   fc 3/19/01  
00186190501 FOSCAVIR INJ 24MG/ML nh 10/8/93   fc 2/1/99  
00186190601 FOSCAVIR INJ 24MG/ML nh 10/8/93   fc 2/1/99  
00192064012 GAMIMUNE N INJ 5%       fc 2/1/99 12/31/00
00192064020 GAMIMUNE N INJ 5%       fc 2/1/99 12/31/00
00192064025 GAMIMUNE N INJ 5%       fc 2/1/99 12/31/00
00192064071 GAMIMUNE N INJ 5%       fc 2/1/99 12/31/00
00192064912 GAMIMUNE N INJ 10%       fc 2/1/99 12/31/00
00192064920 GAMIMUNE N INJ 10%       fc 2/1/99 12/31/00
00192064924 GAMIMUNE N INJ 10%       fc 2/1/99 12/31/00
00192064971 GAMIMUNE N INJ 10%       fc 2/1/99 12/31/00
00209856020 PENTAMIDINE INJ 300MG nh 7/1/96 12/31/00 fc 2/1/99 12/31/00
00310027110 SEROQUEL TAB 100MG nh 12/7/99   fc 12/7/99  
00310027210 SEROQUEL TAB 200MG nh 12/7/99   fc 12/7/99  
00310027460 SEROQUEL 300MG TAB nh 11/13/00   fc 11/13/00  
00310027510 SEROQUEL TAB 25MG nh 12/7/99   fc 12/7/99  
00364082201 VALPROIC ACID CAP 250MG nh 3/19/01   fc 3/19/01  
00364213916 VALPROIC ACID SYRUP 250MG/5ML nh 3/19/01   fc 3/19/01  
00378082501 CLOZAPINE TAB 25MG nh 7/28/99   fc 7/28/99  
00378086001 CLOZAPINE TAB 100MG nh 7/28/99   fc 7/28/99  
00469011310 PENTAM 300 INJ 300MG nh 2/15/96   fc 2/1/99  
00469060767 PROGRAF CAP 0.5MG nh 3/15/99   fc 3/15/99  
00469061771 PROGRAF CAP 1MG nh 2/1/96   fc 2/1/99  
00469065771 PROGRAF CAP 5MG nh 2/1/96   fc 2/1/99  
00469087715 NEBUPENT NEB 300MG nh 6/11/97   fc 2/1/99  
00469113091 PENTAM 300 INJ 300/MG VIA nh 4/15/92   fc 2/1/99  
00469301601 PROGRAF INJ 5MG/ML nh 2/1/96   fc 2/1/99  
00469877090 NEBUPENT 300 MG/VIAL nh 4/15/92   fc 2/1/99  
00603184058 VALPROIC ACID SYRUP 250MG/5ML nh 3/19/01   fc 3/19/01  
00603633421 VALPROIC ACID CAP 250MG nh 3/19/01   fc 3/19/01  
00665412006 VALPROIC ACID CAP 250MG nh 3/19/01   fc 3/19/01  
00677107901 VALPROIC ACID CAP 250MG nh 3/19/01   fc 3/19/01  
00677115533 VALPROIC ACID SYRUP 250MG/5ML nh 3/19/01   fc 3/19/01  
00703505103 DESMOPRESSIN INJ 4MCG/ML nh 10/20/97   fc 2/1/99  
00703505401 DESMOPRESSIN INJ 4MCG/ML nh 10/20/97   fc 2/1/99  
00781220301 VALPROIC ACID CAP 250MG nh 3/19/01   fc 3/19/01  
00781670116 VALPROIC ACID SYRUP 250MG/5ML nh 3/19/01   fc 3/19/01  
00832100700 VALPROIC ACID CAP 250MG nh 3/19/01   fc 3/19/01  
00904210160 VALPROIC ACID CAP 250MG nh 3/19/01   fc 3/19/01  
00904210316 VALPROIC ACID SYRUP 250MG/5ML nh 3/19/01   fc 3/19/01  
00944058101 PROPLEX T INJ FACT IX nh 7/27/92   fc 2/1/99  
00944065001 AUTOPLEX T INJ nh 7/27/92 12/31/00 fc 2/1/99 12/31/00
00944262001 GAMMAGARD SD INJ 0.5GM HU       fc 2/1/99  
00944262002 GAMMAGARD SD INJ 2.5GM HU       fc 2/1/99  
00944262003 GAMMAGARD SD INJ 5GM HU       fc 2/1/99  
00944262004 GAMMAGARD SD INJ 10GM HU       fc 2/1/99  
00944293501 HEMOFIL M HU INJ 200-1000 nh 7/27/92   fc 2/1/99  
13143032152 NYBCEN PED nh 7/27/92 12/31/00 fc 2/1/99 12/31/00
13143032153 NYBCEN ADULT nh 7/27/92 12/31/00 fc 2/1/99 12/31/00
17236035301 VALPROIC ACID CAP 250MG nh 3/19/01   fc 3/19/01  
24208034205 DESMOPRESSIN SPRAY 0.01% nh 1/25/99   fc 2/1/99  
38245063307 VALPROIC ACID SYRUP 250MG/5ML nh 3/19/01   fc 3/19/01  
44087108801 SAIZEN INJ 5MG       fc 2/14/01  
49669160200 VENOGLOBU-I INJ2.5GM       fc 2/1/99 12/31/00
49669160300 VENOBLOBU-I INJ5GM       fc 2/1/99 12/31/00
49669161201 VENOGLOBUL-S INJ 5% HUM       fc 2/1/99  
49669161301 VENOGLOBU-S INJ 5% HUM       fc 2/1/99  
49669161401 VENOGLOBUL-S INJ 5% HUM       fc 2/1/99  
49669162201 VENOGLOBUL-S INJ 10% HUM       fc 2/1/99  
49669162301 VENOGLOBUL-S INJ 10% HUM       fc 2/1/99  
49669162401 VENOGLOBUL-S INJ 10% HUM       fc 2/1/99  
49669370001 PROFILNINE INJ 500U nh 7/27/92 12/31/00 fc 2/1/99 12/31/00
49669370002 PROFILNINE INJ 1000U nh 7/27/92 12/31/00 fc 2/1/99 12/31/00
49669390001 ALPHANINE INJ 100-650 nh 7/27/92 12/31/00 fc 2/1/99 12/31/00
49669390002 ALPHANINE INJ 651-2000 nh 7/27/92 12/31/00 fc 2/1/99 12/31/00
49669410001 PROFIL SD HU INJ 100-650 nh 7/27/92 12/31/00 fc 2/1/99 12/31/00
49669410002 PROFIL SD HU INJ 651-2000 nh 7/27/92 12/31/00 fc 2/1/99 12/31/00
49669420001 PROFILATE-HP INJ 250IU HU nh 7/27/92 12/31/00 fc 2/1/99 12/31/00
49669420002 PROFILATE-HP INJ 750IU HU nh 7/27/92 12/31/00 fc 2/1/99 12/31/00
49669430001 PROFI OSD HU INJ 100-650 nh 7/27/92 12/31/00 fc 2/1/99 12/31/00
49669430002 PROFI OSD HU INJ 651-2000 nh 7/27/92 12/31/00 fc 2/1/99 12/31/00
50111085201 VALPROIC ACID CAP 250MG nh 3/19/01   fc 3/19/01  
50242001820 NUTROPIN INJ 2X10MG       fc 2/1/99  
50242002219 NUTROPIN AQ INJ 5MG/ML       fc 2/1/99  
50242002308 NUTROPIN AQ INJ 5MG/ML       fc 2/1/99  
50242007202 NUTROPIN INJ 2X5MG       fc 2/1/99  
50242011411 NUTROPIN AQ INJ 5MG/ML       fc 2/1/99  
50383079216 VALPROIC ACID SYRUP 250MG/5ML nh 3/19/01   fc 3/19/01  
50419052101 BETASERON INJ 0.3MG nh 9/1/93 12/31/00 fc 2/1/99 12/31/00
50419052103 BETASERON INJ 0.3MG nh 9/30/94   fc 2/1/99  
50419052105 BETASERON INJ 0.3MG nh 1/1/94 12/31/00 fc 2/1/99 12/31/00
50419052115 BETASERON INJ 0.3MG nh 9/30/94   fc 2/1/99  
50458030006 RISPERDAL TAB 1MG nh 4/1/97   fc 2/1/99  
50458030050 RISPERDAL TAB 1MG nh 4/1/97   fc 2/1/99  
50458030104 RISPERDAL TAB 0.25MG nh 7/12/99   fc 7/12/99  
50458030150 RISPERDAL TAB 0.25MG nh 7/12/99   fc 7/12/99  
50458030206 RISPERDAL TAB 0.5MG nh 7/12/99   fc 7/12/99  
50458030250 RISPERDAL TAB 0.5MG nh 7/12/99   fc 7/12/99  
50458030503 RISPERDAL SOL 1MG/ML nh 8/28/98   fc 2/1/99  
50458030510 RISPERDAL SOL 1MG/ML nh 4/1/97 12/31/00 fc   12/31/00
50458032006 RISPERDAL TAB 2MG nh 4/1/97   fc 2/1/99  
50458032050 RISPERDAL TAB 2MG nh 4/1/97   fc 2/1/99  
50458033006 RISPERDAL TAB 3MG nh 4/1/97   fc 2/1/99  
50458033050 RISPERDAL TAB 3MG nh 4/1/97   fc 2/1/99  
50458035006 RISPERDAL TAB 4MG nh 4/1/97   fc 2/1/99  
50962022661 VALPROIC ACID SYRUP 250MG/5ML nh 3/19/01   fc 3/19/01  
51079029820 VALPROIC ACID CAP 250MG nh 3/19/01   fc 3/19/01  
52544042616 VALPROIC ACID SYRUP 250MG/5ML nh 3/19/01   fc 3/19/01  
52555068801 VALPROIC ACID CAP 250MG nh 3/19/01   fc 3/19/01  
52769011502 IMMUNE GLOBU INJ HUMAN       fc 2/1/99 12/31/00
52769027071 PANGLOBULIN INJ 1GM       fc 2/1/99  
52769027073 PANGLOBULIN INJ 3GM       fc 2/1/99  
52769027076 PANGLOBULIN INJ 6GM       fc 2/1/99  
52769027082 PANGLOBULIN INJ 12GM       fc 2/1/99  
52769046001 MONARC M INJ 308-1170 nh 7/27/92   fc 2/1/99  
52769057622 IMMUNE GLOBU INJ HUMAN       fc 2/1/99  
52769077071 IMMUNE GLOBUINJ1GM/33ML       fc 2/1/99  
52769077073 IMMUNE GLOBUINJ3GM/100M       fc 2/1/99  
54129022204 FEIBA VH INJ nh 7/27/92   fc 2/1/99  
54569177203 RETROVIR CAP 100MG nh 7/1/97   fc 2/1/99  
54569422101 EPIVIR TAB 150MG nh 7/1/97   fc 2/1/99  
55513012601 EPOGEN INJ 2000U/ML nh 6/7/89   fc 2/1/99  
55513012610 EPOGEN INJ 2000U/ML nh 1/1/94   fc 2/1/99  
55513014401 EPOGEN INJ 10000/ML nh 6/2/89   fc 2/1/99  
55513014410 EPOGEN INJ 10000/ML nh 1/1/94   fc 2/1/99  
55513014801 EPOGEN INJ 4000U/ML nh 6/2/89   fc 2/1/99  
55513014810 EPOGEN INJ 4000U/ML nh 1/1/94   fc 2/1/99  
55513026701 EPOGEN INJ 3000U/ML nh 4/26/90   fc 2/1/99  
55513026710 EPOGEN INJ 3000U/ML nh 1/1/94   fc 2/1/99  
55513028310 EPOGEN INJ 20000/ML nh 1/3/95   fc 2/1/99  
555130 01 EPOGEN INJ 20000/ML nh 3/10/97   fc 2/1/99  
55513047810 EPOGEN INJ 20000/ML nh 3/10/97   fc 2/1/99  
55513082301 EPOGEN INJ 40000/ML nh 2/8/99   fc 2/8/99  
55513082310 EPOGEN INJ 40000/ML nh 2/8/99   fc 2/8/99  
55566502001 DESMOPRESSIN SOLN 0.01% nh 11/13/00   fc 11/13/00  
55566502002 DESMOPRESSIN SOLN 0.01% nh 7/1/96   fc 2/1/99  
55566503001 DESMOPRESSIN INJ 4MCG/ML nh 11/13/00   fc 11/13/00  
55566504001 DESMOPRESSIN INJ 4MCG/ML nh 11/13/00   fc 11/13/00  
55688010602 HYATE:C INJ 400-700U nh 7/27/92   fc 2/1/99  
57317021006 NEBUPENT NEB 300MG nh 4/15/92 12/31/00 fc 2/1/99 12/31/00
57317021103 PENTAM 300 INJ 300MG nh 4/15/92 12/31/00 fc 2/1/99 12/31/00
59627000103 AVONEX INJ 33MCG nh 12/7/99   fc 12/7/99  
59627000104 AVONEX INJ 30MCG nh 12/7/99   fc 12/7/99  
59676030201 PROCRIT INJ 2000U/ML nh 1/1/94   fc 2/1/99  
59676030202 PROCRIT INJ 2000U/ML nh 1/1/94   fc 2/1/99  
59676030301 PROCRIT INJ 3000U/ML nh 1/1/94   fc 2/1/99  
59676030302 PROCRIT INJ 3000U/ML nh 1/1/94   fc 2/1/99  
59676030401 PROCRIT INJ 4000U/ML nh 1/1/94   fc 02/01/99  
59676030402 PROCRIT INJ 4000U/ML nh 1/1/94   fc 2/1/99  
59676031001 PROCRIT INJ 10000/ML nh 1/1/94   fc 2/1/99  
59676031002 PROCRIT INJ 10000/ML nh 1/1/94   fc 2/1/99  
59676031200 PROCRIT INJ 10000/ML nh 10/24/94   fc 2/1/99  
59676031201 PROCRIT INJ 10000/ML nh 10/24/94   fc 2/1/99  
59676032001 PROCRIT INJ 20000/ML nh 3/3/97   fc 2/1/99  
59676034001 PROCRIT INJ 40000U/M nh 1/25/99   fc 2/1/99  
60432062116 VALPROIC ACID SYRUP 250MG/5ML nh 3/19/01   fc 3/19/01  
60574210101 RESPIGAM SOL 50 MG/ML       fc 2/1/99  
60574210201 RESPIGAM SOL 50 MG/ML       fc 2/1/99 12/31/00
60574310101 CYTOGAM INJ       fc 2/1/99  
60574310201 CYTOGAM INJ       fc 2/1/99 12/31/00
60574411101 SYNAGIS INJ 100MG nh 11/1/98   fc 2/1/99  
60574411201 SYNAGIS INJ 50MG nh 2/1/00   fc 2/1/00  
63010001027 VIRACEPT TAB 250MG nh 3/14/97   fc 2/1/99  
63010001030 VIRACEPT TAB 250MG nh 11/24/99   fc 11/24/99  
63010001190 VIRACEPT POW 50MG/GM nh 3/14/97   fc 2/1/99  
63323087715 NEBUPENT NEB 300MG nh 4/26/99   fc 4/26/99  

REVISED FEE SCHEDULES
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Book

During June 2001, revised Medicaid fee schedules will be sent to enrolled providers in the following categories:

Clinical Psychology, Clinical Social Worker, Midwife, Nurse Practitioner, Ophthalmic, Ordered Ambulatory, Physician and Podiatry Services Providers.

Coding and fee changes will be effective for dates of service on and after July 1, 2001. New codes are in bold type. Please review the revised fee schedule carefully and insert it into your MMIS Provider Manual. Previous copies of the fee schedule should be kept on hand for billing purposes for periods of service prior to July 1, 2001.

If you do not receive a revised fee schedule (Provider Manual update) by June 15, 2001, please contact Computer Sciences Corporation's Provider Relations at:

Clinical Psychology,Clinical Social Worker, Nursing Services which includes
(Midwife COS 0525 and Nurses COS 0521/0522), Practitioner, Ophthalmic, Physician, Podiatry Services		 Practitioner Services
(800) 522-5518
(518) 447-9860
Ordered Ambulatory, Nursing Registries (COS 0523/0524)Institutional Services
(800) 522-1892
(518) 447-9810

Questions regarding coding changes should be directed to the Medicaid Bureau of Medical Review and Payment at 518-474-8161.

ATTENTION NEW PROVIDERS
Schedule of Medicaid Seminars for New Providers
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Computer Sciences Corporation (CSC), the fiscal agent for the New York State Medicaid Management Information System (MMIS), announces the following schedule of Introductory Seminars. Topics will include:

  • Overview of MMIS
  • Explanation of MMIS Provider Manual
  • Discussion of Medicaid Managed Care
  • Overview of Billing Options
  • Explanation of 90-day Regulation
  • Explanation of Utilization Threshold Program

Please indicate the seminar(s) you wish to attend below:

July 10, 2001 . 10 AM
Ulster County Dept. of Social Services
Albany Avenue
Kingston, NY

July 19, 2001 . 10 AM
Tompkins County Department of Social Services
320 West State Street, 1st Floor Conference Room
Ithaca, NY

July 25, 2001 . 10 AM
Broome County Self-Sufficiency Center
435 West State Street, Training Room C
Binghamton, NY

August 9, 2001 . 10 AM
Westchester County Dept. of Social Services
85 Court Street
White Plains, NY

August 14, 2001 . 10 AM
Suffolk County Department of Social Services
3085 Veterans Memorial Highway
Ronkonkoma, NY

Additional seminars may be scheduled as new programs are implemented or changes to existing billing procedures are announced.

Please complete the following registration information:

Provider Name:___________________________________
Provider ID:________________________

Provider Category of Service:________________________
Number Attending:___________________

Contact Name:___________________________________
Phone Number:______________________

If the seminar address is not listed above, a CSC representative will contact you at least two weeks prior to the seminar date to confirm attendance and provide seminar address information. Please register early to attend sites marked with (*) because seating is limited. Each seminar will last approximately two hours. Direct questions about these seminars to CSC as follows:

Practitioner Services    (800) 522-5518    (518) 447-9860
Institutional Services    (800) 522-1892    (518) 447-9810
Professional Services    (800) 522-5535    (518) 447-9830

To register, please mail this completed page to:

Computer Sciences Corporation
Attn.: Provider Outreach
800 North Pearl Street
Albany, NY 12204

Or, fax a copy of the completed page to: 518-447-9240

Note: Please keep a copy of your seminar choice for your records. No written confirmations will be sent.

Thank you for participating in New York State's Medicaid program.

The Medicaid Update: Your Window Into The Medicaid Program

The State Department of Health welcomes your comments or suggestions regarding the Medicaid Update.

Please send suggestions to the editor, Timothy Perry-Coon:

NYS Department of Health
Office of Medicaid Management
Bureau of Program Guidance
99 Washington Ave., Suite 720
Albany, NY 12210
(e-mail MedicaidUpdate@health.state.ny.us)

The Medicaid Update, along with past issues of the Medicaid Update, can be accessed online at the New York State Department of Health web site: http://www.health.state.ny.us/health_care/medicaid/program/main.htm