...Part II POLICIES AND PROCEDURES FOR THE PHYSICIANS’ INJECTABLE DRUG LIST GEORGIA DEPARTMENT OF COMMUNITY HEALTH DIVISION OF MEDICAL ASSISTANCE PLANS Published October 1, 2013 PREFACE The Physicians’ Injectable Drug List (PIDL) manual contains basic information regarding Georgia’s Fee for Service (FFS) Medicaid and PeachCare for Kids programs and should be used in conjunction with Policies and Procedures Manual for Medicaid and PeachCare for Kids Part I, Part II Policies and Procedures Manual for Physician Services, and other applicable program manuals. We urge you and your office staff to familiarize yourselves with the contents of this manual and refer to it when questions arise. Use of the manuals will assist in the elimination of misunderstandings concerning the coverage levels and billing procedures that can result in delays of claims processing or payments, inaccuracies and/or denials. The PIDL is reviewed and updated quarterly, it is re-priced annually. Drugs that are not re-priced by the manufacturer or are no longer manufactured, or obsolete may not be re-priced or changed— refer to the Schedule of Maximum Allowable Payments (Appendix A) in this manual. For quality purposes, the PIDL is periodically purged of drugs with no or low (fewer than 50 units of service annually) utilization over a three (3) year period; except for orphan drugs and certain chemotherapeutic agents. Requests for coverage of purged drugs will be considered on a case-bycase...
Words: 9265 - Pages: 38
...Essentials Ruth E. McCall, BS, MT (ASCP) Retired Program Director and Instructor Central New Mexico Community College Albuquerque, New Mexico President, NuHealth Educators, LLC Faculty, Emeritus Phoenix College Phoenix, Arizona Fifth Edition Cathee M. Tankersley, BS, MT (ASCP) Acquisitions Editor: Peter Sabatini Product Manager: Meredith L. Brittain Marketing Manager: Shauna Kelley Designer: Holly McLaughlin Production Services: Aptara, Inc. Fifth Edition Copyright © 2012, 2008 by Lippincott Williams & Wilkins, a Wolters Kluwer business. Two Commerce Square 2001 Market Street Philadelphia, PA 19103 351 West Camden Street Baltimore, MD 21201 Printed in China All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at permissions@lww.com, or via website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Library of Congress...
Words: 129902 - Pages: 520
...------------------------------------------------- Somatoform disorder From Wikipedia, the free encyclopedia Somatoform disorder | Classification and external resources | ICD-10 | F45 | ICD-9 | 300.8 | DiseasesDB | 1645 | eMedicine | med/3527 | MeSH | D013001 | In psychology, a somatoform disorder is a mental disorder characterized by physical symptoms that suggest physical illness or injury – symptoms that cannot be explained fully by a general medical condition, direct effect of a substance, or attributable to another mental disorder (e.g. panic disorder).[1] The symptoms that result from a somatoform disorder are due to mental factors. In people who have a somatoform disorder, medical test results are either normal or do not explain the person's symptoms. Patients with this disorder often become worried about their health because the doctors are unable to find a cause for their health problems. This causes severe stress, due to preoccupations with the disorder that portrays an exaggerated belief about the severity of the disorder. [2]Symptoms are sometimes similar to those of other illnesses and may last for several years. Usually, the symptoms begin appearing during adolescence, and patients are diagnosed before the age of 25 years. [3] Somatoform disorders are not the result of conscious malingering (fabricating or exaggerating symptoms for secondary motives) or factitious disorders (deliberately producing, feigning, or exaggerating symptoms) – sufferers...
Words: 12343 - Pages: 50
...Anthropology Lecture 1 introduction Common Misconceptions with Drugs . The effect of a drug is caused solely by its pharmacological properties and effects. . Some drugs are instantly addictive . The gateway/ stepping stone theory - the use of 1 drug leads to the use of other more dangerous drugs What are drugs ? Krivanek's definition : Drugs are substances that are introduced into the body knowingly but not as food. Therefore illicit drugs, legal recreational drugs and legal but regulated pharmaceutical drugs that aren't recreational at all. - Whether if a drug is considered bad and is prohibited depends on the culture of the society in a particular period. What is culture ? The definition of culture = Through Roger keesing and Andrew Strathern's definition it is a system of shared ideas, rules and meanings that underlie and are expressed in the ways that human live. - This includes : law, beliefs, political economy, media and popular culture - this perceives ideas about what is normal and abnormal to society. " Culture is always changing and contested, not unified" Enthography as a method for studying drug use It is a process of observing, recoding and describing other peoples way of life through intimate participation the community being studied". - Participation observation, involving yourself in the life of the community , taking up the life of the other person, observing their actions, asking questions and learning what questions...
Words: 21869 - Pages: 88