Topics Related to All Providers
The following new or amended combined North Carolina Medicaid and NC Health Choice clinical coverage policies are available on Medicaid’s Clinical Coverage Policy web pages.
Centers for Medicare & Medicaid Services (CMS) is overhauling and streamlining the Electronic Health Record (EHR) Incentive Program. The goal is to move the program beyond requirements for meaningful use (MU) to increase focus on interoperability and improving patient access to health information.
Effective Oct. 1, 2017, Clinical Coverage Policy 2B-1, Nursing Facility Services, was revised in accordance with 42 CFR 483 Subpart B.
Clinical Coverage Policy 11A-15, Hematopoietic Stem-Cell Transplantation for Solid Tumors of Childhood, has been revised.
Effective July 1, 2018, North Carolina Medicaid has revised Clinical Coverage Policy (CCP) 1-O-3, Keloid Excision and Scar Revision, to clarify the procedure for proper submission of preoperative photographs to CSRA as part of the prior approval process. The preoperative photographs of keloids or scars should be clearly marked with:
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.
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.
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.