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Numbered Memoranda Year 2004

Memo #	Status	Description	Date Issued
04-106 Postcard Notification	Superseded	Planned Home Births/Births in Birthing Centers: Newborn Screening Fee Correction [Superseded by new Planned Home Births/Births in Birthing Centers Billing Instructions 1/2005] Postcard Mailed 12/8/04	12/1/04
04-105 Reissued Postcard Notification		REISSUED: Family Planning Services & Family Planning-Only Program: Fee Schedule Changes Postcard Mailed 12/ /04	12/13/04 Reissued 12/22/04
04-104 Postcard Notification		Oxygen & Respiratory Therapy: Fee Schedule Changes Postcard Mailed 12/ /05	12/21/04
04-103	VOID
04-102 Postcard Notification		Prosthetic and Orthotic Devices: Fee Schedule Changes Postcard Mailed 12/5/05	12/30/04
04-101	VOID
04-100	VOID
04-99 Postcard Notification		Nondurable Medical Supplies and Equipment: Fee Schedule Changes Note: Page G.25 updated per 05-24maa. Postcard Mailed 1/5/05	12/30/04
04-98	VOID
04-97 Postcard Notification		Wheelchairs, Durable Medical Equipment (DME), and Supplies: Fee Schedule Changes Note: Updated online with IC-2005-1. Postcard Mailed 1/5/05	12/30/04
04-96 Postcard Notification		Medical Nutrition: HCPCS Code Deletions Postcard Mailed 1/5/04	12/30/04
04-95 Postcard Notification		Outpatient Hospitals Updates: Year 2004 CPT and HCPCS Postcard Mailed 1/5/05	12/30/04
04-94	VOID
04-93 (rescinded) Postcard Notification		Ambulatory Surgery Centers: Fee Schedule Update Rescinded by 05-22 MAA Postcard Mailed 1/4/05	12/30/04
04-92 Postcard Notification		Neurodevelopmental Centers: Fee Schedule Changes Postcard Mailed 12/10/04	12/10/04
04-91 Postcard Notification	Superseded	Dental Program (Adults/Children): Fee Schedule Changes Postcard Mailed 12/23/04 Superseded by new Dental Billing Instructions	12/17/04
04-90 Postcard Notification		Physician-Related Services: 2005 Changes and Additions to CPT® and HCPCS Codes, Policies, and Fee Schedule Postcard Mailed 1/5/05	12/30/04
04-89 Postcard Notification		Speech/Audiology Program: Fee Schedule Changes Postcard Mailed 12/10/04	12/10/04
04-88 Postcard Notification		Physical Therapy Program: Fee Schedule Changes Postcard Mailed 12/10/04	12/10/04
04-87 Postcard Notification		Early Periodic Screening, Diagnosis, and Treatment (EPSDT) Clinics: New Codes and Fee Updates Postcard Mailed 1/5/05	12/30/04
04-86 Postcard Notification		Prescription Drug Program: Maximum Allowable Cost Update Postcard Mailed 12/30/04	12/27/04
04-85 Postcard Notification		Year 2005 Healthy Options, Basic Health Plus, Primary Care Case Management, and SCHIP Updates Postcard Mailed 12/10/04	12/6/04
04-84 Postcard Notification		Prescription Drug Program: Washington Preferred Drug List & Expedited Prior Authorization Changes Updates: 01/10/05: Added note to page N.1. 12/09/04: Updated pages N.1 and N.2: MAA removed the words "no change in code/criteria" beside the drug "pravachol." MAA removed "methadose" and "Oramorph SR" from the "long-acting opiodes" row and removed the "SA" after "morphine sulfate." Postcard Mailed 12/7/04	12/1/04
04-83 Postcard Notification		Prescription Drug Program: Maximum Allowable Cost Update Postcard Mailed 12/9/04	12/6/04
04-81 Postcard Notification		Prescription Drug Program: Maximum Allowable Cost Update Postcard Mailed 11/15/04	11/8/04
04-80 Postcard Notification	Retroactive: 10/01/04 Thru 03/31/05	Physician-Related Services: Coverage & Rate Updates for Influenza Virus Vaccines *Updated 11/18/04:* Page 4 - MAA added an asterisk to code 90660 in the chart and removed the phrase "for clients 19 years of age and older" from the intro sentence above the chart. Postcard Mailed 11/17/04	11/10/04
04-79 Postcard Notification		Prescription Drug Program: Preferred Drug List, Drug Limitations, and Expedited Prior Authorization Updates Postcard Mailed 11/12/04	11/3/04
04-78 Postcard Notification		Mandatory Managed Care Program for GAU Clients in King and Pierce Counties Postcard mailed 11/1/04 Special Hard Copy Memo Mailing 11/8/04	10/25/04
04-77 Postcard Notification		Prescription Drug Program: PA and Limitation Updates Postcard Mailed 11/8/04	10/28/04
04-76 Postcard Notification		Termination of the 24-hour Rule, HCPCS Code Usage and Guidelines, OPPS Implementation, Fee Schedule Changes, and Revenue Code Grid Updates Postcard Mailed 11/3/04	10/22/04
04-75 Postcard Notification	Rescinded	Nondurable Medical Supplies and Equipment (MSE): Correction to Rate for Diaper Doublers Effective November 1, 2004, MAA has rescinded this memorandum. Postcard Mailed 11/1/04	~~10/26/04~~ Rescinded
04-74 Postcard Notification		Oxygen and Respiratory Therapy Program: Change in Limitation and Purchase Price of CPAP Device Postcard Mailed 10/15/04	10/15/04
04-73 Postcard Notification	Superseded	Planned Home Births and Births in Birthing Centers: Fee Schedule Corrections [Superseded by new Planned Home Births/Births in Birthing Centers Billing Instructions 1/2005] Postcard Mailed 10/22/04	10/15/04
04-72 Postcard Notification		Prescription Drug Program - Maximum Allowable Cost Update Postcard Mailed 11/28/04	10/20/04
04-71 Postcard Notification		Washington Medicaid Integration Partnership (WMIP) Project: Update Postcard Mailed 10/15/04	10/08/04
04-70 Postcard Notification		Prescription Drug Program: Expedited Prior Authorization and Drug Limitation Updates Updated 10/6/04: Changed text relating to Vioxx® (Rofecoxib) on page 3 of the memorandum. It now reads: "Vioxx® (Rofecoxib) has been removed from the market by the manufacturer; therefore, it is no longer available for payment." Postcard Mailed 10/15/04	9/30/04 Updated 10/6/04
04-69 Postcard Notification		Prescription Drug Program - Maximum Allowable Cost Update Postcard Mailed 9/29/04	9/16/04
04-68 MAA	Superseded	Access to Baby and Child Dentistry (ABCD): Third-Party Insurance Payments to be Deducted Prior to MAA's Payment Superseded by new ABCD Dental Billing Instructions	8/30/04
04-67 MAA Postcard Notification		Wheelchairs, Durable Medical Equipment (DME), and Supplies: “Other DME” Fee Schedule Changes and Prior Authorization Changes Postcard Mailed 10/15/04	9/30/04
04-66 MAA Postcard Notification		Children’s Office Visits and EPSDT Screening Fees Corrections Postcard Mailed 9/28/04	9/20/04
04-65 MAA Postcard Notification		Prescription Drug Program - Preferred Drug List and Expedited Authorization Updates Postcard Mailed 9/10/04	8/30/04
04-64 MAA Postcard Notification		Prescription Drug Program - Unit Dose Reimbursement Updates Postcard Mailed 9/10/04	8/20/04
04-63 MAA Postcard Notification		Prescription Drug Program - Maximum Allowable Cost Update Postcard Mailed 9/10/04	8/12/04
04-62 MAA Postcard Notification		Indian Health Services: Encounter Rate Increase Updated 07/30/04: Page two of attachment was inadvertently left blank. Fixed. Superseded by Tribal Health Program Billing Instructions published in June 2006 Postcard Mailed 8/17/04	7/26/04 Updated 07/30/04
04-61 MAA Postcard Notification		Prescription Drug Program - Maximum Allowable Cost Update Postcard Mailed 7/29/04	7/16/04
04-60 MAA Postcard Notification		CUP Women Program: Changes in Authorization and Program Administration Postcard Mailed 7/20/04	7/12/04
04-59 MAA Postcard Notification		Prescription Drug Program - Prior Authorization Changes Postcard Mailed 8/20/04	7/30/04
04-58 MAA Postcard Notification		Prescription Drug Program - Maximum Allowable Cost Update Postcard Mailed 7/1/04	6/28/04
04-57 MAA Postcard Notification		Spoken Language Interpreter Services: New Broker Contracts Awarded and Reimbursement Granted for No-Shows and Cancelled Appointments Postcard Mailed 7/1/04	6/24/04
04-56 MAA Postcard Notification		Washington Medicaid Integration Partnership (WMIP) Project Postcard Mailed 7/27/04	7/15/04
04-55 MAA Postcard Notification		New Medical Identification (ID) Card Postcard Mailed 6/23/04	6/15/04
End of July 2004 Fee Schedule Updates
04-54 MAA		No Vendor Rate Increase for the 2005 State Fiscal Year (for the following programs:) · Adult Day Health; · Ambulatory Surgery Centers; · Chemical Dependency; · Diabetes Education; · Ground and Air Ambulance Transportation; · Hearing Aids & Services; · HIV/AIDS Case Management; · Home Health; · Hospice · Involuntary Treatment Act Transportation · Medical Nutrition; · Prescription Drug Program; and · Private Duty Nursing for Children	6/30/04
04-53 MAA		Speech/Audiology Program: Fee Schedule Changes	6/10/04
04-52 MAA		Physician-Related Services: Fee Schedule Changes w/attached Billing Instructions	7/06/04
04-51 MAA		Psychologist Program: Fee Schedule Changes	6/14/04
04-50 MAA		Prosthetic and Orthotic (P&O) Devices: Fee Schedule Changes	6/15/04
04-49 MAA	Superseded	Prenatal Diagnosis Genetic Counseling: Fee Schedule Changes Updated 07/21/04: Page 15, maximum allowable fee for procedure code was increases to $38.75.	6/30/04 Updated 07/21/04
04-48 MAA		Physical Therapy Program: Fee Schedule Changes	6/14/04
04-47 MAA		Outpatient Hospitals: Program Updates and Fee Schedule Changes	7/1/04
04-46 MAA		Vision Care Program: Fee Schedule Changes	6/14/04
04-45 MAA		Occupational Therapy Program: Fee Schedule Changes	6/14/04
04-44 MAA		Medical Supplies and Equipment (MSE): Fee Schedule Changes Note: Page G.20 updated per 05-24maa.	6/15/04
04-43 MAA		Neurodevelopmental Centers: Fee Schedule Changes	6/21/04
04-42 MAA		Medical Nutrition Therapy: Fee Schedule Changes	6/30/04
04-41 MAA		Maternity Support Services/Infant Case Management: ICM Intake Criteria, Tobacco Cessation Performance Measure, and Fee Schedule Changes *Updated 11/12/04:* Fixed DSHS Forms web address on pgs iii, B.8, B.9, B.10, C.2, C.3.	6/22/04 Updated 11/12/04
04-40 MAA	Superseded	Planned Home Births and Births in Birthing Centers: Fee Schedule Changes and Maternity Policy Updates *Updated 7/22/04:* Corrected several fees in the fee schedule. [Superseded by new Planned Home Births/Births in Birthing Centers Billing Instructions 1/2005]	6/23/04 Updated 7/22/04
04-39 MAA		Home Infusion Therapy/Parenteral Nutrition Program: Procedure Code Changes and Fee Schedule Changes *Updated 11/03/04:* Pg E6 - Adjusted limits for K0601-K0603 to match limits published in memo 04-39maa.	6/21/04 Updated 11/03/04
04-38 MAA	Superseded	Kidney Center Services: Fee Schedule Changes [Superseded by new Kidney Center Srvcs Billing Instructions]	6/30/04
04-37MAA Reissue should be 03-37 Reissue Postcard Notification		Diabetes Education Program: Fee Schedule Update & Discontinued State-Unique Procedure Codes Attention! When MAA published the postcard for the reissue of # Memo 03-37 MAA on January 1, 2005, MAA erroneously printed "04-37 MAA Reissue" on the postcard rather than "03-37 MAA Reissue." MAA has fixed this error. MAA did not reissue # Memo 04-37 MAA on January 1, 2005. The link to the left will take you to the reissued memo. Postcard Mailed 12/27/04	1/5/05
04-37 MAA		Family Planning Services and Family Planning Only Program: Fee Schedule Changes Updated 7/26/04: This memo was reissued on 6/30/04 and then updated on-line 7/23/04 and 7/26/04. The updates correct fees in the fee schedule.	6/23/04 Reissued 6/30/04 Updated 7/26/04
04-36 MAA REISSUE		Early Periodic Screening, Diagnosis, and Treatment (EPSDT) Clinics: Fee Schedule and Billing Instruction Changes *Updated 11/12/04:* Fixed DSHS Forms web address on pgs C.3 and D.5. *Reissued 7/22/04:* This memo was corrected and re-issued 7/22/04. We corrected fees in the fee schedule and added info on Lead Toxicity Screening.	6/30/04 Reissued 7/22/04
04-35 MAA	Superseded	Dental Program: Fee Schedule Changes Superseded by new Dental Billing Instructions	6/24/04
04-34 MAA		Chiropractic Services for Children: Fee Schedule Changes	6/30/04
04-33 MAA		Oxygen and Respiratory Therapy Program: Fee Schedule Changes	7/1/04
04-32 MAA		July 1, 2004 Fee Schedule Changes, Procedure Code Updates, and Program Changes	6/21/04
04-31 MAA		Blood Bank Services: Fee Schedule Changes *Updated 10/26/04:* Retroactive to claims with dates of service on and after July 1, 2004, MAA corrected the fees for procedure codes 85576 and 36430 in the fee schedule.	6/10/04 Updated 10/26/04
July 2004 Fee Schedule Updates
04-30 MAA Postcard Notification		Prescription Drug Program: Preferred Drug List Updates, Prior Authorization Changes, and Limitations on Certain Drugs Postcard Mailed 6/30/04	6/15/04
04-29 MAA Postcard Notification		Home Infusion Therapy/Parenteral Nutrition Therapy - Billing Instructions Changes Postcard Mailed 6/14/04	6/5/04
04-28 Postcard Notification	Superseded	Orthodontic Services Program Updates Postcard Mailed 12/30/04 Superseded by new Dental Billing Instructions	12/22/04
04-27 MAA Postcard Notification		Quality Chart Reviews of Client Medical Records Updated 7/26/04: Corrected phone number for the Medical Assistance Customer Service Line. Postcard Mailed 7/16/04	7/9/04 Updated 7/26/04
04-26 MAA Postcard Notification	Superseded	Kidney Center Services: Additional Billable HCPCS J-codes Postcard Mailed 5/25/04 [Superseded by new Kidney Center Srvcs Billing Instructions]	5/13/04
04-25 MAA Postcard Notification		Prescription Drug Program - Maximum Allowable Cost Update Postcard Mailed 5/25/04	5/17/04
04-24 MAA Postcard Notification		Maternity Support Services/Infant Case Management – Reimbursement Rate Revisions Postcard Mailed 5/19/04	5/10/04
04-23 MAA Postcard Notification		Prescription Drug Program: Prior Authorization Updates Updated 05/13/04: On page H.10 and H.12, removed code 044 from EPA criteria of Lamisil and Sporanox. Postcard Mailed 5/17/04	5/7/04 Updated 05/13/04
04-22 MAA Postcard Notification		Rescinding the NDC Requirement for Drugs Administered in the Provider’s Office Postcard Mailed 4/20/04	4/9/04
04-21 MAA Postcard Notification		Prescription Drug Program: MAC Updates Postcard Mailed 4/20/04	4/12/04
04-20 MAA Postcard Notification		Prescription Drug Program: Introduction of Therapeutic Interchange Program Postcard Mailed 4/22/04	4/16/04
04-19 MAA Postcard Notification		Oxygen and Respiratory Therapy Program Billing Instructions and Fee Schedule Updates Postcard Mailed 4/26/04	4/20/04
04-18 MAA Postcard Notification		Prosthetic and Orthotic Devices (P&O): New and Deleted HCPCS Codes, Policy Changes, and Billing Clarifications Postcard Mailed 4/22/04	4/15/04
04-17 MAA Postcard Notification		Wheelchairs, Durable Medical Equipment (DME), and Supplies Billing Instruction and Fee Schedule Updates Postcard Mailed 4/30/04	4/20/04
04-16 MAA Postcard Notification		Non-Durable Medical Supplies and Equipment (MSE): New and Deleted HCPCS Codes, Policy Changes, and Billing Clarifications Updated 08/10/04: # Memorandum 04-16 MAA introduced changes to the Washington State EPA Criteria Coding List located in section E of the MSE Billing Instructions. MAA inadvertently put the new criteria on page E.7 and left the old criteria as a duplicate on page E.6. MAA has now removed the old criteria and has updated pages E.6-E.8. This does not constitute a change in policy, only the removal of old, incorrect information. Note: Page G.25 updated per 05-24maa. Postcard Mailed 4/20/04	4/15/04
04-15 MAA Postcard Notification		Reissued - Prescription Drug Program: Updates to the Preferred Drug List and Prior Authorization Postcard Mailed 4/6/04	Reissued 3/29/04
04-14 MAA Postcard Notification		Medical Nutrition Program: Product List and Policy Changes Postcard Mailed 4/13/04	4/6/04
04-13 MAA Postcard Notification	Superseded	Non-Durable Medical Supplies and Equipment (MSE): Fee Schedule Revisions [Superseded by 04-44] Postcard Mailed 4/6/04	3/29/04
04-12 MAA Postcard Notification	Superseded	Kidney Center Services - Updates Postcard Mailed 3/29/04 [Superseded by new Kidney Center Srvcs Billing Instructions]	3/23/04
04-11 MAA Postcard Notification		Maximum Allowable Cost List Update Postcard Mailed 3/22/04	3/16/04
04-10 MAA Postcard Notification		Occupational Therapy – Aquatic Therapy Services (CPT code 97113) Added to Coverage Effective April 1, 2004 Postcard Mailed 4/8/04	3/31/04
04-09 MAA Postcard Notification		Authorization Number for Medical Inpatient Detoxification (MID) Services Postcard Mailed 3/19/04	3/10/04
04-08 MAA Postcard Notification		Maximum Allowable Cost List Update Postcard Mailed 3/4/04	2/23/04
04-07 MAA	VOID
04-06 MAA Postcard Notification		Maternity Support Services/Infant Case Management – Reimbursement for Doula Services Discontinued Postcard Mailed 3/2/04	2/25/04
04-05 MAA Postcard Notification		Updates to the Prescription Drug Program Postcard Mailed 2/6/04	1/30/04
04-04 MAA Postcard Notification		Maximum Allowable Cost List Update Postcard Mailed 1/21/04	1/14/04
04-03 MAA Postcard Notification	Superseded	Dental Program Changes and Updates Postcard Mailed 2/27/04 Superseded by new Dental Billing Instructions	2/23/04
04-02 MAA Postcard Notification		Dispensing Fee Payments & Pharmacy Services Washington Administrative Code (WAC) Update Postcard Mailed 1/27/04	1/9/04
04-01 MAA Postcard Notification		Prescription Drug Program - EPA Codes and Criteria Changes Updated *02/17/04:* Listed Abilify with code and criteria, Geodon with code and criteria, and Risperdal with code and criteria. Referred Seroquel and Zyprexa to the Risperdal criteria. Bextra, code 079 criteria modified. Postcard Mailed 1/9/04	12/31/03 Updated 02/17/04

Page modified: January 2010

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