Topics Related to Bulletins
Medicaid has been made aware of reimbursement delays when claims for medical services are billed for inpatient services with a psychiatric diagnosis as the primary diagnosis.
If a provider’s enrollment application or Manage Change Request (MCR) does not contain errors, it will process more quickly. The NCTracks Enrollment Team identified commons errors that cause delays in processing applications and MCRs.
Registration is open for the August 2018 instructor-led provider training courses listed below. Slots are limited.
The following new or amended combined North Carolina Medicaid and NC Health Choice clinical coverage policies are available on Medicaid’s website:
As previously communicated in the July 2018 North Carolina Medicaid Special Bulletin, the NPI Exemption List will cease Aug. 31, 2018, for Clinical Pharmacist Practitioners (CPPs), Residents and Interns.
NC-MIPS is accepting Program Year 2018 Modified Stage 2 and Stage 3 MU attestations.
Effective with date of service May 1, 2018, the North Carolina Medicaid and N.C. Health Choice programs covers fosnetupitant and palonosetron for injection, for intravenous use (Akynzeo) for use in the Physician’s Drug Program when billed with HCPCS code J3490 - Unclassified drugs.
Effective July 1, 2018, the North Carolina Medicaid and N.C. Health Choice programs will cover nusinersen injection, for intrathecal use (Spinraza) for use only in the Physician's Drug Program.
Effective with date of service March 8, 2018, the North Carolina Medicaid and N.C. Health Choice (NCHC) programs cover mometasone furoate sinus implant (Sinuva) for use in the Physician's Drug Program (PDP) when billed with HCPCS code J3490 - Unclassified drugs. One Sinuva Sinus Implant system contains 1350 mcg of mometasone furoate and a sterile delivery system.
Effective with date of service April 1, 2018, the North Carolina Medicaid and N.C. Health Choice programs cover fibrinogen concentrate (human) lyophilized powder for reconstitution (Fibryga) for use in the Physician’s Drug Program when billed with HCPCS code J3590 - Unclassified biologics.