Registration is open for several instructor-led training courses for providers that will be held in May 2018. Slots are limited.
Topics Related to Bulletins
In response to provider comments and questions regarding the December 2017 Special Bulletin, Billing Guidance:340B Modifiers, North Carolina Medicaid is publishing updated information regarding the use of the JG, TB and UD modifiers which are required to identify 340B drug claims.
The NC Division of Medical Assistance (DMA) currently recognizes CPT Code 27216 (Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral).
42 CFR 455.450 requires a state Medicaid agency to screen all initial provider applications based on a categorical risk level of “limited,” “moderate,” or “high.”
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.
The NC Medicaid Electronic Health Record (EHR) Incentive Program is no longer accepting Program Year 2017 attestations.
Topics include: list of providers due for re-credentialing, changes to re-credentialing process and changes to ongoing verification process.
On July 21, 2017, the Centers for Medicare & Medicaid Services notified North Carolina Medicaid that its State Plan Amendment (SPA TN17-0003) had been reviewed and was approved effective April 1, 2017.
North Carolina Medicaid was recently made aware that several manufacturers of viscous hyaluronic acid products changed the status of their products from “drugs” to “devices” effective Oct. 24, 2017 and are therefore no longer offering rebate agreements with the Centers of Medicare & Medicaid Services.
Effective with date of service Jan. 30, 2018, the North Carolina Medicaid and NC Health Choice (NCHC) programs cover Coagulation Factor IX (Recombinant), GlycoPEGylated, lyophilized powder for solution for intravenous injection (Rebinyn) for use in the Physician’s Drug Program (PDP) when billed with HCPCS code J7199 - Hemophilia clotting factor, not otherwise classified.