Note: This article was originally published as a Special Bulletin in January 2018, with updates regarding clinical pharmacist practitioners.
Topics Related to Bulletins
The following new or amended combined North Carolina Medicaid and NC Health Choice clinical coverage policies are available on Medicaid’s Clinical Coverage Policy web pages.
Centers for Medicare & Medicaid Services (CMS) is overhauling and streamlining the Electronic Health Record (EHR) Incentive Program. The goal is to move the program beyond requirements for meaningful use (MU) to increase focus on interoperability and improving patient access to health information.
Effective Oct. 1, 2017, Clinical Coverage Policy 2B-1, Nursing Facility Services, was revised in accordance with 42 CFR 483 Subpart B.
Clinical Coverage Policy 11A-15, Hematopoietic Stem-Cell Transplantation for Solid Tumors of Childhood, has been revised.
Effective July 1, 2018, North Carolina Medicaid has revised Clinical Coverage Policy (CCP) 1-O-3, Keloid Excision and Scar Revision, to clarify the procedure for proper submission of preoperative photographs to CSRA as part of the prior approval process.
Effective Jan. 1, 2018, North Carolina Medicaid increased the rates for mammography procedure codes 77065, 77066, and 77067. Medicaid has identified the claims that have been affected by this change.
On June 1, 2018, hospitals, physicians, physician assistants and nurse practitioners with an electronic health record system must have initiated a connection to NC HealthConnex, North Carolina’s designated statewide health information exchange network.
This announcement is to inform Community Alternatives Program for Children providers of revisions to the technical changes in Clinical Coverage Policy, 3K-1, Community Alternatives Program for Children (CAP/C).
In response to provider comments and questions regarding billing under the new federal Ordering, Prescribing and Referring (OPR) rules, North Carolina Medicaid is issuing this clarification for radiology and Independent Diagnostic Testing Facilities (IDTF).