Topics Related to All Providers
There are only four months left to submit an attestation for Program Year 2017.
Clinical Coverage Policy (CCP) 11B-4, Kidney (Renal) Transplantation, has been revised.
The revisions, which will become effective Feb. 1, 2018, will remove the prior authorization requirement from live donor kidney transplants and reflect coverage based on glomerular filtration rate (GFR) and age, rather than diagnosis.
The revisions, which will become effective Feb. 1, 2018, will remove the prior authorization requirement from live donor kidney transplants and reflect coverage based on glomerular filtration rate (GFR) and age, rather than diagnosis.
The following new or amended combined N.C. Medicaid and N.C. Health Choice clinical coverage policies are available on DMA’s clinical coverage policy web pages.
Appropriate maternal depression screening is necessary to ensure that postpartum depression is addressed and care is administered in a timely manner to improve quality of care and long-term outcomes for both mother and child. Maternal depression screening identifies mothers who may be suffering from depression and may lead to treatment or discussion of referral strategies for appropriate treatment.
The provision of family planning services and family planning-related services has been the sole purpose of the “Be Smart” Family Planning Medicaid program since it started in October 2005, and continued with the CMS approval of the State Plan Amendment in 2014.
The N.C. Medicaid and N.C. Health Choice (NCHC) application fee is $100, which covers costs associated with processing enrollment applications. The $100 application fee is required for both in-state and border-area (within 40 miles) providers during initial enrollment and when providers complete the five-year reverification process.
The Centers for Medicare & Medicaid Services announced an increase in the Affordable Care Act provider enrollment application fee.
Effective Oct. 29, 2017, NCTracks will implement a quarterly Maintain Eligibility Process which identifies providers with no claim activity within the past 12 months. The provider must attest electronically in NCTracks to remain active.
The American Medical Association (AMA) publishes an annual Current Procedural Terminology (CPT) manual each fall outlining new, revised, and deleted procedural codes effective January 1 of the following calendar year. (For complete information regarding all code and description changes, refer to the 2018 edition of Current Procedural Terminology.) N.C. Medicaid reviews these codes changes to determine clinical coverage for the Medicaid program.
Effective Feb. 1, 2018, N.C. Medicaid will cover balloon sinus ostial dilatation (BOD) surgery. The BOD policy will outline the new coverage for applicable CPT procedure codes.