Enrollment applications submitted with incorrect data including name, social security number and date of birth result in application denials and withdrawals. As a result, providers must submit new applications and pay any applicable fees.
Topics Related to Bulletins
Effective Dec. 31, 2018, CPT code 58565 (Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants) will no longer be covered by NC Medicaid.
Clinical Policy 1E-7, Family Planning Services, has been revised and posted on the NC Medicaid website.
Hematopoietic Stem-Cell Transplantation for Central Nervous System Embryonal Tumors & Ependymoma, 11A-10 has been revised effective Nov. 1, 2018.
Effective Oct. 1, 2018, providers can now bill for CPT code 81420 (fetal chromosomal aneuploidy). Procedure is limited to three units per 365 days.
The following new or amended Medicaid and NC Health Choice clinical coverage policies were posted since Oct. 1, 2018. Visit the NC Medicaid website to view the policies.
Proposed Clinical Coverage Policies for Public Comment
Effective Sept. 15, 2018, Clinical Coverage Policy 10A, Outpatient Specialized Therapies, was updated to increase therapy visit limits for recipients 21 years of age and older.
Personal Care Services (PCS) regional training sessions will be held Oct. 18-Nov. 1, 2018.
The Department of Health and Human Services is implementing the Referral Screening Verification Process for individuals being considered for admission to an Adult Care Home effective Nov. 1, 2018.