Revised Effective Jan. 31, 2019: Clinical Coverage Policy 3K-1, Specialized Medical Equipment and Supplies for Adaptive Car Seat and Vehicular Transport Vest

NC Medicaid-Enrolled Durable Medical Equipment Providers and Community Alternatives Program for Children Case Management Entities

Effective Jan. 31, 2019, NC Medicaid’s Community Alternatives Program for Children (CAP/C) approves specialized medical equipment and supplies for an adaptive car seat and a vehicular transport vest for participants in CAP/C when all qualifying conditions are met per the CAP/C Clinical Coverage Policy, 3K-1. The billing procedure code is E0700. This billing procedure code is also used by Durable Medical Equipment (DME) providers. 

When a request is approved for an adaptive car seat or a vehicular transport vest through CAP/C, the following requirements must be met for the claim to adjudicate:

1. Have a Managed Change Request (MCR) approved to provide waiver supplies for CAP/C under non-endorsed services for taxonomy 332B00000X. If an MCR is not under your non-endorsed services, you must initiate this process in NCTracks. 
2. Have a service authorization from a CAP/C case management entity approving the rendering of an adaptive car seat or a vehicular transport vest by your agency.
3. Have a Prior Approval segment on file in NCTracks authorizing the date of service and reimbursement amount for an adaptive car seat or a vehicular transport vest.
4. Submit the claim using billing procedure code E0700.