This bulletin applies to NC Medicaid Direct and NC Medicaid Managed Care.
NC Medicaid will expand laboratory coverage to include the codes below. For information regarding the collecting and transportation of laboratory specimens, please refer to clinical coverage policy 1S-3: Laboratory Services. Providers can access this policy on the NC Medicaid Program Specific Clinical Coverage Policies webpage.
Newly Covered Procedure Codes
0202U - Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qualitative RT-PCR, nasopharyngeal swab, each pathogen reported as detected or not detected.
For beneficiaries enrolled in a managed care plan, providers should contact the appropriate health plan for additional guidance on claims submission and coverage.
Contact
NCTracks Call Center: 800-688-6696
NC Medicaid Managed Care Health Plans