Clinical Coverage Policy Update

Monday, January 13, 2020

The following new or amended clinical coverage policies are available on the NC Medicaid Clinical Coverage Policies web page at https://medicaid.ncdhhs.gov/providers/clinical-coverage-policies.

Clinical Coverage Policy 3D, Hospice Services - December 2019

  • Clinical Coverage Policy 3D, Hospice Services, has been updated to reflect changes throughout the policy. 
  • Language has been updated to include physician assistant as one who may act as the beneficiary’s attending physician per beneficiary choice according to 42 CFR 418.52(c)(4).
  • Language has been added that addresses documentation requirements for FL2 forms in nursing and long-term care facilities.
  • Expanded details have been added to the Patient Monthly Liability (PML) section.
  • Attachment A: Claims-Related Information Section C. Code 0235- Added: Post Mortem (PM) visit Modifier.
  • Attachment A: D, Modifiers - Added: Post mortem visit reporting.
  • These policies supersede previously published policies and procedures. 
  • Proposed new or amended Medicaid and NC Health Choice clinical coverage policies are posted for comment throughout the month. Visit Proposed Medicaid and NC Health Choice Policies for current posted policies and instructions to submit a comment.
Author: 
Medicaid Clinical Policy, (888) 245-0179