Author: Clinical Policy and Programs
Effective April 1, 2018, when performing a wet mount screening, providers serving Family Planning Medicaid (MAFDN) beneficiaries shall bill procedure code 87210 (smear, primary source with interpretation; wet mount for infectious agents [e.g., saline, India ink, KOH preps]). If both saline and potassium hydroxide (KOH) methods are needed, two units may be billed. Wet mount screenings may be performed during the annual exam or during any of the six inter-periodic visits allowed per 365 days under Family Planning Medicaid, when a sexually transmitted screening is required.
Line items submitted with a service date on or after April 1, 2018, for MAFDN eligible beneficiaries, with Procedure code Q0111 (wet mounts, including preparations of vaginal, cervical or skin specimens) will be denied.
Providers with questions can contact the CSRA Call Center at 1-800-688-6696 or NCTracksprovider@nctracks.com.
Clinical Policy and Programs
DMA, 919-855-4260