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.
Effective May 1, 2019, CPT code 58340 (catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography) will no longer be covered by NC Medicaid.
Topics Related to Bulletins
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
Proposed new or amended Medicaid and NC Health Choice clinical coverage policies are posted for comment throughout the month. Visit the Proposed Medicaid and NC Health Choice Policies for current posted policies and instructions to submit a comment.
As of Nov. 1, 2018, the following NC Medicaid policies are open for public comment:
Proposed new or amended Medicaid and NC Health Choice clinical coverage policies are posted for comment throughout the month. Visit the Proposed Medicaid and NC Health Choice Policies for current posted policies and instructions to submit a comment.
As of Nov. 1, 2018, the following NC Medicaid policies are open 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.
Effective for dates of service on or after Oct. 1, 2018, the following DRG classifications specific to LARCs will be added to the current Grouper 36 version within NCTracks for claims reimbursement.