Family Planning Medicaid provides limited coverage to beneficiaries with MAFDN eligibility.
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The following CPT codes should not be billed with a separate office visit. An office visit component is included in reimbursement for these CPT codes.
Facility providers can access Sterilization Consent Form status including denial reasons, on the secure NCTracks Provider Portal, if the sterilization consent form has been properly completed.
Sterilization claims must be submitted with ICD-10-CM diagnosis Z30.2 (encounter for sterilization) as the primary or secondary diagnosis code on the claim.
It has come to NC Medicaid’s attention that claims for balloon sinus ostial dilation billed with modifier 50 (bilateral), were resulting in an under payment to providers. The issue has been resolved.
The clinical criteria used by NC Medicaid for the 2018/2019 Respiratory Syncytial Virus (RSV) season are consistent with guidance published by the American Academy of Pediatrics (AAP): 2018 – 2021 Report of the Committee on Infectious Diseases, 31th Edition.
Influenza Vaccine and Reimbursement Guidelines for 2018-2019 for Medicaid and NC Health Choice.
On April 2, 2018, General Dynamics Information Technology acquired CSRA Inc. CSRA is now "CSRA State and Local Solutions LLC, A General Dynamics Information Technology Company," or simply "GDIT."
Effective Aug. 1, 2018, the Division of Medical Assistance (DMA) and Division of Health Benefits (DHB) combined into one division called the NCDHHS Division of Health Benefits.
NC Medicaid and Health Choice will reimburse providers for medically necessary drugs and services and equipment and supplies provided during the Hurricane Florence emergency without prior approval from Sept. 14 through Oct. 5, 2018.