Effective July 1, 2018, Cologuard (CPT code 81528) has been approved for colorectal cancer screening.
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In accordance with the NC State Plan, Section 4.19-B, Section 3, Page 1, North Carolina Division of Medical Assistance (DMA) will revise rates for the following laboratory procedure codes: 81220, 81221, 81222, 81223, 81228, 81229, 81243, 81244, 81331, and 81507.
North Carolina Medicaid will reprocess Medicare Part B Crossover Professional and Outpatient claims submitted to Medicare from Jan. 2, 2017, to Jan. 5, 2017.
The following new or amended combined North Carolina and NC Health Choice clinical coverage policies are available on Medicaid’s Clinical Coverage Policy web pages.
New codes and taxonomies have been added to the procedure code list for Nurse Practitioners and Physician Assistants.
Note: This article was originally published as a Special Bulletin in January 2018, with updates regarding clinical pharmacist practitioners.
If a provider’s enrollment application or Manage Change Request does not contain errors, it will process more quickly. The NCTracks Enrollment Team identified commons errors that cause delays in processing applications and MCRs.
Effective with date of service April 1, 2018, the North Carolina Medicaid and N.C. Health Choice programs cover fibrinogen concentrate (human) lyophilized powder for reconstitution (Fibryga) for use in the Physician’s Drug Program when billed with HCPCS code J3590 - Unclassified biologics.
Effective with date of service March 8, 2018, the North Carolina Medicaid and N.C. Health Choice (NCHC) programs cover mometasone furoate sinus implant (Sinuva) for use in the Physician's Drug Program (PDP) when billed with HCPCS code J3490 - Unclassified drugs.
Effective July 1, 2018, the North Carolina Medicaid and N.C. Health Choice programs will cover nusinersen injection, for intrathecal use (Spinraza) for use only in the Physician's Drug Program.
Effective with date of service May 1, 2018, the North Carolina Medicaid and N.C. Health Choice programs covers fosnetupitant and palonosetron for injection, for intravenous use (Akynzeo) for use in the Physician’s Drug Program when billed with HCPCS code J3490 - Unclassified drugs.
Registration is open for the July 2018 instructor-led provider training courses listed below. Slots are limited.
Centers for Medicare & Medicaid Services is streamlining the Electronic Health Record Incentive Program. The goal is to move the program beyond requirements for meaningful use to increase focus on interoperability and improving patient access to health information.
Note: This article was originally published in the June 2018 Medicaid Bulletin with a clarification that only high-risk providers must obtain fingerprints.
Effective Aug. 1, 2018, North Carolina Medicaid will make a change to the North Carolina Medicaid and N.C. Health Choice Preferred Drug List (PDL) in the Antihyperkinesis/Attention Deficit Hyperactivity Disorder (ADHD) class.