Note: This article was previously published in the September 2017 Medicaid Bulletin. It is being republished with updates.
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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.
Registration is open for several instructor-led training courses for providers that will be held in January 2018.
Effective with date of service Oct.
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.