This bulletin applies to NC Medicaid Direct.
Background
NC Medicaid identified a system issue that resulted in denials of chiropractic service claims when providers submitted valid diagnosis codes consistent with Clinical Coverage Policy 1F. The claims affected involved services billed with procedure codes 98940, 98941 and 98942.
Effective Aug. 1, 2024, NC Medicaid will only accept the following ICD-10 diagnosis codes for chiropractic services:
- M99.10
- M99.11
- M99.12
- M99.13
- M99.14
- M99.15
These codes represent diagnoses of spinal subluxation and are the only diagnosis codes that will be recognized for chiropractic claim processing.
Providers may refile previously denied claims with dates of service on or after Aug. 1, 2024, using one of the approved diagnosis codes above. All claims must be submitted in accordance with Clinical Coverage Policy 1F.
Contact
NCTracks Call Center: 1-800-688-6696