Effective Jan. 1, 2018, North Carolina Medicaid increased the rates for mammography procedure codes 77065, 77066, and 77067. Medicaid has identified the claims that have been affected by this change.
A systematic reprocessing for professional, Medicare Part B Crossover Professional, Rural Health Clinic (RHC), Local Health Department (LHD) and Federally Qualified Health Center (FQHC) claims with dates of service Jan. 1, 2018 through Feb. 23, 2018 – that were paid in NCTracks from Jan. 1, 2018 through March 6, 2018 – will be reprocessed in the June 12, 2018, checkwrite.
Topics Related to All Providers
In response to provider comments and questions regarding billing under the new federal Ordering, Prescribing and Referring (OPR) rules, North Carolina Medicaid is issuing this clarification for radiology and Independent Diagnostic Testing Facilities (IDTF).
The Special Medicaid Bulletin, Generic Dispensing Rate Adjustments and Flovent HFA Inhaler Moved to Preferred Status on the Preferred Drug List, had an incorrect date in the first sentence.
Here is the article with the correct information.
Here is the article with the correct information.
Flovent HFA Inhaler Moved to Preferred Status on the Preferred Drug List
Effective Feb. 3, 2017, Flovent HFA Inhaler has been moved to preferred status on the North Carolina Medicaid and NC Health Choice (NCHC) Preferred Drug List (PDL). This change is being made since Teva Pharmaceuticals has discontinued sales of QVAR Inhaler and to allow providers another preferred inhaled corticosteroid option.
Effective Feb. 3, 2017, Flovent HFA Inhaler has been moved to preferred status on the North Carolina Medicaid and NC Health Choice (NCHC) Preferred Drug List (PDL). This change is being made since Teva Pharmaceuticals has discontinued sales of QVAR Inhaler and to allow providers another preferred inhaled corticosteroid option.
The use of the NPI Exemption List for residents and interns enrolled in graduate dental and medical programs, and area health education centers will cease on Jan. 31, 2018. Clinical Pharmacist Practitioners will continue to use the NPI Exemption List until further notice.
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.
Clinical pharmacist practitioners will continue to use the NPI Exemption List until further notice.
Clinical pharmacist practitioners will continue to use the NPI Exemption List until further notice.
By July 1, 2018, Medicaid behavioral health providers added to NCTracks by their current Local Management Entity/Managed Care Organization Provider Upload Process must complete re-verification.
Per Session Law (S.L.) 2015-241, as of June 1, 2018, hospitals, mid-level physicians and nurse practitioners who currently have an electronic health record system must be connected to NC HealthConnex to continue to receive payments for Medicaid and NCHC services.
Note: This article was previously published in the September 2017 Medicaid Bulletin. It is republished with updates regarding edit disposition.
Effective Oct. 29, 2017, the NC Department of Health and Human Services (DHHS) validates through NCTracks that the billing provider’s address submitted on the claim corresponds to the location listed on the provider record for the dates of service submitted. The billing provider address, city, state and zip code (first five digits) on all North Carolina Medicaid and NC Health Choice claims must match exactly with the corresponding information on
Effective Oct. 29, 2017, the NC Department of Health and Human Services (DHHS) validates through NCTracks that the billing provider’s address submitted on the claim corresponds to the location listed on the provider record for the dates of service submitted. The billing provider address, city, state and zip code (first five digits) on all North Carolina Medicaid and NC Health Choice claims must match exactly with the corresponding information on
The implementation of ICD-10-CM allows specificity for accurate coding, resulting in greater justification of medical necessity. A provider’s documentation must include details to completely depict the nature of a beneficiary’s diagnosis and procedures performed.