This bulletin article applies to NC Medicaid Direct.
In accordance with Medicare guidelines, NC Medicaid Direct terminated coverage for CPT code 80050 (General health panel) retroactive to Dec. 31, 2021. For dates of service on or after Jan. 1, 2022, providers are advised to bill for the individual components comprising the general health panel as follows:
| CPT Code | Description |
|---|---|
| 80053 | Comprehensive metabolic panel |
| 85025 | Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count |
| 85027 | Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) |
| 85004 | Blood count; automated differential WBC count |
| 85007 | Blood count; blood smear, microscopic examination with manual differential WBC count |
| 85009 | Blood count; manual differential WBC count, buffy coat |
| 84443 | Thyroid stimulating hormone (TSH) |
NC Medicaid Direct will not recoup claims previously paid for code 80050 for dates of service on or after Jan. 1, 2022. Denials for individual components of 80050, where 80050 was not paid on the same date of service, may be resubmitted with requests for time limit override, if applicable.
Contact
NCTracks Call Center: 800-688-6696