This communication serves as an advisory notice for all Providers. The intent is to increase awareness of the Medicare Advantage Plan. The statement below should be used to gain further clarification regarding claims denied for Medicare Part C coverage.
Topics Related to Bulletins
Effective May 1, 2019, beneficiaries requesting Personal Care Services must use the updated NC Medicaid-3051 Request for Independent Assessment for Personal Care Services Attestation of Medical Need Form. This form is a revision of the currently used NC Medicaid-3051 Form. The current form will be accepted by the Independent Assessment Entity through July 1, 2019.
Effective Mar. 4, 2019, NC Medicaid implemented functionality in QiRePort allowing providers to submit the Internal Quality Improvement Program Attestation (NC Medicaid-3136) and Session Law 2013-306 PCS Training Attestation (NC Medicaid-3085) Forms via upload.
Personal Care Services (PCS) regional training sessions will be held May 13-22, 2019. Registration begins at 8 a.m. and training will be held from 9 a.m. to 1:30 p.m. Training sessions are free, but registration is required.
Effective Dec. 1, 2018, the North Carolina Medicaid Uniform Screening Tool (NCMUST) application and operation of the Level 1 PASRR screen process transitioned from a NC Medicaid vendor to NC DHHS ITD and NC Medicaid. The transition enables NC DHHS to achieve a more efficient screening process for PASRRs and provide NCDHHS with direct knowledge of issues and barriers that may impact the timely processing of PASRR Level 1 screens and Level 2 evaluations.
North Carolina Medicaid has received calls concerning claim denials for some services provided by nurse practitioners (NPs) and physician assistants (PAs).
North Carolina Medicaid has provided instructions to NCTracks and the following procedure code list has been updated recently to include additional NP and PA taxonomies.
North Carolina Medicaid has received calls concerning claim denials for some services provided by nurse practitioners (NPs) and physician assistants (PAs).
Medicaid has provided instructions to NCTracks and the following procedure code list has been updated recently to include additional NP and PA taxonomies.
Nuzyra is available as 100 mg of omadacycline (equivalent to 131 mg omadacycline tosylate) as a lyophilized powder in a single dose vial for reconstitution and further dilution before intravenous infusion.
Effective with date of service of Feb. 4, 2019, the North Carolina Medicaid and NC Health Choice programs cover fluocinolone acetonide intravitreal implant (Yutiq) for use in the Physician Administered Drug Program when billed with HCPCS code J7313 Injection, fluocinolone acetonide, intravitreal implant, 0.01 mg.
Effective with date of service Jan. 3, 2019, the North Carolina Medicaid and NC Health Choice programs cover pegfilgrastim-cbqv injection, for subcutaneous use (Udenyca) for use in the Physician Administered Drug Program when billed with HCPCS code Q5111 - Injection, pegfilgrastim-cbqv, biosimilar, (Udenyca), 0.5 mg.