Topics Related to Bulletins

Effective April 1, 2018, when performing a wet mount screening, providers serving Family Planning Medicaid (MAFDN) beneficiaries shall bill procedure code 87210 (smear, primary source with interpretation; wet mount for infectious agents [e.g., saline, India ink, KOH preps]).

Facility providers can now access Sterilization Consent Form status, including denial reasons, on the secure NCTracks Provider Portal.

Registration is open for the February 2018 instructor-led provider training courses listed below. Slots are limited.

Effective May 1, 2017, new pharmacy point of sale clinical edits for behavioral health medications were applied for pediatric and adult beneficiaries.

Providers have until April 30, 2018, to submit a complete and accurate attestation for Program Year 2017.

If a provider’s enrollment application or Manage Change Request (MCR) is clean and does not contain errors, it will process more quickly. The NCTracks Enrollment Team identified commons errors that cause delays in processing applications and MCRs.

The following new or amended combined North Carolina Medicaid and NC Health Choice clinical coverage policies are available on North Carolina Medicaid’s Clinical Coverage Policy web pages.

This article covers: Clinical Coverage Policy 12B and State Plan Amendment, 2018 Recertification Process, Stakeholder Engagement and, History and Purpose of HIV Case Management Services.

Effective Jan. 15, 2018, updates to Clinical Coverage Policy 3D, Hospice Services, are approved. The amended policy is posted to the North Carolina Medicaid website.

Effective with date of service Nov. 8, 2017, the North Carolina Medicaid program covers zoster vaccine recombinant, adjuvanted, suspension for intramuscular injection (Shingrix) for use in the Physician’s Drug Program (PDP) when billed with CPT code 90750 - Zoster (shingles) vaccine, (HZV), recombinant, sub-unit, adjuvanted, for intramuscular injection.