Topics Related to All Providers
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.
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.
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.
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.
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.
Clinical Policy 1E-7, Family Planning Services, has been revised and posted on the NC Medicaid website.
Hematopoietic Stem-Cell Transplantation for Central Nervous System Embryonal Tumors & Ependymoma, 11A-10 has been revised effective Nov. 1, 2018.
Effective Oct. 1, 2018, providers can now bill for CPT code 81420 (fetal chromosomal aneuploidy). Procedure is limited to three units per 365 days.
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.
Proposed Clinical Coverage Policies for Public Comment
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.
As of Nov. 1, 2018, the following NC Medicaid policies are open for public comment:
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.
As of Nov. 1, 2018, the following NC Medicaid policies are open for public comment:
Effective with date of service Aug. 17, 2018, the Medicaid and NC Health Choice programs cover plazomicin injection, for intravenous use (Zemdri) for use in the Physician's Drug Program when billed with HCPCS code J3490-Unclassified drugs.