Blog Entry List

This email is an update to yesterday’s email and previous North Carolina Medicaid Bulletins. In response to provider feedback, the use of the NPI Exemption List for residents and interns enrolled in graduate dental and medical programs, and area health education centers will be extended from January 31, 2018 to April 30, 2018.

The Freestanding Birth Center fee for CPT Code 59409 has been updated to $1,510.97 effective Jan. 1, 2018.

With each prior approval (PA) entry beginning with the third and subsequent benefit periods, providers must fax a copy of the Approval Status Inquiry Form, or the NCTracks Web Submitted Request for Hospice Prior Approval Confirmation Page, to DMA at 919-715-9025. DMA requests that providers include their name and e-mail address on the above forms.

Note: This article was previously published in the September 2017 Medicaid Bulletin. It is being republished with updates.

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. 

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.

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 Centers for Medicare & Medicaid Services announced an increase in the Affordable Care Act provider enrollment application fee.

The N.C. Medicaid and N.C. Health Choice (NCHC) application fee is $100, which covers costs associated with processing enrollment applications.

The provision of family planning services and family planning-related services has been the sole purpose of the “Be Smart” Family Planning Medicaid program since it started in October 2005, and continued with the CMS approval of the State Plan Amendment in 2014.

Appropriate maternal depression screening is necessary to ensure that postpartum depression is addressed and care is administered in a timely manner to improve quality of care and long-term outcomes for both mother and child.

The following new or amended combined N.C. Medicaid and N.C. Health Choice clinical coverage policies are available on DMA’s clinical coverage policy web pages.

Clinical Coverage Policy (CCP) 11B-4, Kidney (Renal) Transplantation, has been revised.

There are only four months left to submit an attestation for Program Year 2017.

Per Session Law (S.L.) 2015-241, as amended by S.L. 2017-57, North Carolina providers who are reimbursed by the state for providing health care services under N.C. Medicaid and N.C. Health Choice programs must join NC HealthConnex, the state-designated Health Information Exchange.