Topics Related to Bulletins
Effective Aug. 1, 2018, North Carolina Medicaid will make a change to the N.C. Medicaid and N.C. Health Choice Preferred Drug List in the Antihyperkinesis/Attention Deficit Hyperactivity Disorder (ADHD) class.
Effective July 1, 2018, CPT Code 95012, Fractional Exhaled Nitric Oxide (FENO) measurement, is approved in the assessment of pediatric beneficiaries with suspicion of asthma and for asthma management. Exhaled nitric oxide measurement is considered medically necessary and is covered when used as an adjunct with spirometry.
FENO measurement is considered medical necessary to:
FENO measurement is considered medical necessary to:
Medicaid’s Third-Party Liability contractor, Health Management Systems, Inc., will implement a Commercial Insurance Disallowance project to streamline North Carolina’s coordination of benefits and direct billing processes. The expected date for implementation is Oct. 1, 2018.
These guidelines assist with claim submissions for dually eligible beneficiaries. This information addresses situations known to affect a significant number of claims. It is not feasible to provide an all-inclusive list due to the variable nature of the programs.
Effective Aug. 1, 2018, North Carolina Medicaid will make a change to the North Carolina Medicaid and N.C. Health Choice Preferred Drug List (PDL) in the Antihyperkinesis/Attention Deficit Hyperactivity Disorder (ADHD) class.
Note: This article was originally published in the June 2018 Medicaid Bulletin with a clarification that only high-risk providers must obtain fingerprints.
Centers for Medicare & Medicaid Services is streamlining the Electronic Health Record Incentive Program. The goal is to move the program beyond requirements for meaningful use to increase focus on interoperability and improving patient access to health information.
Registration is open for the July 2018 instructor-led provider training courses listed below. Slots are limited.
Effective with date of service April 1, 2018, the North Carolina Medicaid and N.C. Health Choice (NCHC) programs cover ibalizumab-uiyk injection, for intravenous use (Trogarzo) for use in the Physician’s Drug Program (PDP) when billed with HCPCS code J3590 - Unclassified biologics.
The procedure code list for nurse practitioners (NPs) and physician assistants (PAs) has been updated recently to include additional NP and PA taxonomies.
11306 (B)
11311 (B)
27093
27093 (B)
36598
36598 (B)
*Codes marked with a (B) were updated for modifier 59
11306 (B)
11311 (B)
27093
27093 (B)
36598
36598 (B)
*Codes marked with a (B) were updated for modifier 59