This bulletin article applies to NC Medicaid Direct.
NC Medicaid Direct has added coverage for the following diagnosis codes, retroactive to April 1, 2023:
| Diagnosis Code | Description |
|---|---|
| Z31.430 | Encounter of female for testing for genetic disease carrier status for procreative management |
| Z31.440 | Encounter of male for testing for genetic disease carrier status for procreative management |
NC Medicaid Direct will not re-process claims previously denied for diagnosis code(s) Z31.430 and Z31.440 for dates of service on or after April 1, 2023. Denials for these claims may be resubmitted with requests for time limit override, if applicable.
Please refer to NC Medicaid Clinical Coverage Policy 1S-4 Genetic Testing located at Program Specific Clinical Coverage Policies webpage for full coverage details regarding carrier status testing services.
Contact
NCTracks Call Center: 800-688-6696