Topics Related to Bulletins
Effective Oct. 29, 2017, NCTracks will implement a quarterly Maintain Eligibility Process which identifies providers with no claim activity within the past 12 months. The provider must attest electronically in NCTracks to remain active.
The American Medical Association (AMA) publishes an annual Current Procedural Terminology (CPT) manual each fall outlining new, revised, and deleted procedural codes effective January 1 of the following calendar year. (For complete information regarding all code and description changes, refer to the 2018 edition of Current Procedural Terminology.) N.C. Medicaid reviews these codes changes to determine clinical coverage for the Medicaid program.
Effective Feb. 1, 2018, N.C. Medicaid will cover balloon sinus ostial dilatation (BOD) surgery. The BOD policy will outline the new coverage for applicable CPT procedure codes.
Note: This article was previously published in the September 2017 Medicaid Bulletin. It is being republished with updates.
Note: This article was originally published in the October 2017 Medicaid Bulletin. This is the final Medicaid Bulletin publication.
‘High risk” individual providers and provider organizations, as outlined in NC General Statute 108C-3g, and individual owners with 5 percent or more direct or indirect ownership interest in a “high risk” organization are required to submit fingerprints to the N.C. Medicaid program.
‘High risk” individual providers and provider organizations, as outlined in NC General Statute 108C-3g, and individual owners with 5 percent or more direct or indirect ownership interest in a “high risk” organization are required to submit fingerprints to the N.C. Medicaid program.
Note: This article is being republished monthly. It was originally published in the December 2017 Medicaid Bulletin with revisions.
Effective with date of service Jan. 1, 2018, the following dental procedure codes were added for the N.C. Medicaid and Health Choice Dental Programs. These additions are a result of updates to the Current Dental Terminology (CDT) 2018 American Dental Association (ADA) Code. Clinical Coverage Policy 4A, Dental Services, will be updated to reflect these changes.
Effective with date of service Oct. 23, 2017, the N.C. Medicaid and N.C. Health Choice (NCHC) programs cover meropenem and vaborbactam for injection, for intravenous use (Vabomere) for use in the Physician's Drug Program (PDP) when billed with HCPCS code J3490 - Unclassified drugs. Vabomere 2 grams for injection is supplied as a sterile powder for constitution in single-dose vials containing meropenem 1 gram (equivalent to 1.14 grams of meropenem trihydrate) and vaborbactam 1 gram.
Effective with date of service Oct. 15, 2017, the NC Medicaid Program covers triamcinolone acetonide extended-release injectable suspension, for intra-articular use (Zilretta) for use in the Physician’s Drug Program (PDP) when billed with HCPCS code J3490 - Unclassified drugs. Zilretta is currently commercially available as a single-dose kit containing one vial of Zilretta microsphere powder (32 mg of triamcinolone acetonide), one vial of 5 mL diluent, and one sterile vial adapter.