Topics Related to All Providers
Registration is open for the September 2018 instructor-led provider training courses.
NC-MIPS is accepting Program Year 2018 Modified Stage 2 and Stage 3 MU attestations.
In response to provider requests and to allow reimbursement for behavioral health integration in primary care settings, North Carolina Medicaid is adding coverage for the following evaluation and management codes effective October 1, 2018.
Family Planning Medicaid provides limited coverage to beneficiaries with MAFDN eligibility.
The following CPT codes should not be billed with a separate office visit. An office visit component is included in reimbursement for these CPT codes.
Facility providers can access Sterilization Consent Form status including denial reasons, on the secure NCTracks Provider Portal, if the sterilization consent form has been properly completed.
Sterilization claims must be submitted with ICD-10-CM diagnosis Z30.2 (encounter for sterilization) as the primary or secondary diagnosis code on the claim.
It has come to NC Medicaid’s attention that claims for balloon sinus ostial dilation billed with modifier 50 (bilateral), were resulting in an under payment to providers. The issue has been resolved.
The clinical criteria used by NC Medicaid for the 2018/2019 Respiratory Syncytial Virus (RSV) season are consistent with guidance published by the American Academy of Pediatrics (AAP): 2018 – 2021 Report of the Committee on Infectious Diseases, 31th Edition.
Influenza Vaccine and Reimbursement Guidelines for 2018-2019 for Medicaid and NC Health Choice.