Undocumented aliens and certain legal aliens who have not resided in the U.S. for more than five years do not qualify for full Medicaid assistance, but do qualify for medical emergency services. NC Medicaid covers dialysis to undocumented aliens as an emergency service in a facility where licensed professionals monitor the condition of the beneficiary during each episode of care. Once the beneficiary is stable enough to receive in-home hemodialysis without benefit of the immediate attention of the medical provider, the treatment is no longer an emergency service.
Effective July 1, 2020, Procedure Code J0887, Mircera Injection, Epoetin Beta, 1 Microgram, (FOR ESRD ON DIALYSIS) was added to dialysis related procedure codes allowed to be billed for emergency dialysis for undocumented aliens eligible for hemodialysis-related services.
Claim denials for Procedure Code J0887 billed after July 1, 2020 that have denied with EOB 00246 Service Not Allowed For Undocumented Aliens, may be rebilled.
Contact
NCTracks Call Center: 800-688-6696