Effective with date of service, Aug. 1, 2018, the Medicaid and NC Health Choice programs cover Lutathera for use in the Physician’s Drug Program when billed with HCPCS code A9699, Radiopharmaceutical, therapeutic, not otherwise classified.
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Effective with date of service May 1, 2018, the North Carolina Medicaid and N.C. Health Choice programs covers fosnetupitant and palonosetron for injection, for intravenous use (Akynzeo) for use in the Physician’s Drug Program when billed with HCPCS code J3490 - Unclassified drugs.
Effective July 1, 2018, the North Carolina Medicaid and N.C. Health Choice programs will cover nusinersen injection, for intrathecal use (Spinraza) for use only in the Physician's Drug Program.
Effective with date of service March 8, 2018, the North Carolina Medicaid and N.C. Health Choice (NCHC) programs cover mometasone furoate sinus implant (Sinuva) for use in the Physician's Drug Program (PDP) when billed with HCPCS code J3490 - Unclassified drugs.
Effective with date of service April 1, 2018, the North Carolina Medicaid and N.C. Health Choice programs cover fibrinogen concentrate (human) lyophilized powder for reconstitution (Fibryga) for use in the Physician’s Drug Program when billed with HCPCS code J3590 - Unclassified biologics.
Effective with date of service April 1, 2018, the North Carolina Medicaid and N.C. Health Choice (NCHC) programs cover ibalizumab-uiyk injection, for intravenous use (Trogarzo) for use in the Physician’s Drug Program (PDP) when billed with HCPCS code J3590 - Unclassified biologics.
On June 1, 2018, hospitals, physicians, physician assistants and nurse practitioners with an electronic health record system must have initiated a connection to NC HealthConnex, North Carolina’s designated statewide health information exchange network.
In response to the higher than normal number of influenza cases and influenza-related complications and deaths, North Carolina Medicaid is offering telephonic evaluation and management services to beneficiaries who are actively experiencing flu-like symptoms.
North Carolina Medicaid was recently made aware that several manufacturers of viscous hyaluronic acid products changed the status of their products from “drugs” to “devices” effective Oct. 24, 2017 and are therefore no longer offering rebate agreements with the Centers of Medicare & Medicaid Services.
Effective with date of service Jan. 30, 2018, the North Carolina Medicaid and NC Health Choice (NCHC) programs cover Coagulation Factor IX (Recombinant), GlycoPEGylated, lyophilized powder for solution for intravenous injection (Rebinyn) for use in the Physician’s Drug Program (PDP) when billed with HCPCS code J7199 - Hemophilia clotting factor, not otherwise classified.