Blog Entry List
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.
Effective Oct. 1, 2018, providers can now bill for CPT code 81420 (fetal chromosomal aneuploidy). Procedure is limited to three units per 365 days.
Hematopoietic Stem-Cell Transplantation for Central Nervous System Embryonal Tumors & Ependymoma, 11A-10 has been revised effective Nov. 1, 2018.
Clinical Policy 1E-7, Family Planning Services, has been revised and posted on the NC Medicaid website.
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.
Enrollment applications submitted with incorrect data including name, social security number and date of birth result in application denials and withdrawals. As a result, providers must submit new applications and pay any applicable fees.
The Upload Documents page on the Secure Provider Portal now allows providers to upload up to 20 enrollment-related documents, an increase over the previous maximum of 10 documents. This feature may, for example, be of use to a provider needing to upload documents in support of an affirmative response to an exclusion sanction question or a provider responding to a notice advising that an application is incomplete and additional documentation is required.
Providers now have the option to withdraw an application by clicking on the "Withdraw" hyperlink on the Status and Management page of their NCTracks record.
Registration is open for the November 2018 instructor-led provider training courses listed below. Slots are limited.
WebEx courses can be attended remotely from any location with a telephone, computer and internet connection. Onsite courses include hands-on training and are limited to 45 participants. They are offered in-person at the GDIT facility at 2610 Wycliff Road in Raleigh.
Following are details on the courses, including dates, times and how to enroll.
AMH Attestation (WebEx)
Friday, Nov. 9, 2018, 9:30–11 a.m.
The NC Medicaid EHR Incentive Program’s Quick Tip Webinar Series has been updated to reflect the rules and regulations for Program Year 2018. This article also covers Promoting Interoperability Reporting Period and NC Medicaid EHR Incentive Payment System is Open for Program Year 2018.
The Money Follows the Person Demonstration Project is preparing for the 2019-2023 Medicaid Transition Period and has updated its application for the coming year. MFP will continue to transition individuals on Medicaid from skilled level, long-term care facilities back to the community until all populations are folded into Medicaid Managed Care. The new application will be posted on the MFP website after Nov. 1, 2018. This new application will be effective Jan.
Providers are reminded that NC Medicaid flexibilities due to Hurricane Florence end on Oct. 5, 2018.
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.
The following new or amended Medicaid and NC Health Choice clinical coverage policies were posted since Aug. 31, 2018.
North Carolina health care providers are required by law to connect with NC HealthConnex, North Carolina’s designated health information exchange.