Medicaid Bulletin
SPECIAL BULLETIN: Medicaid Bulletin Holiday Posting Schedule
In preparation for the upcoming holidays, please be aware of the change to the schedule for posting of Medicaid Bulletin articles.
Clinical Coverage Policies
New or amended clinical coverage policies are available on NC Medicaid’s website.
Updated ICD Diagnosis Code List
NC Medicaid has updated its ICD-10 diagnosis code list.
Enrollment for CAP/DA Direct Service Informational Webinar
The Community Alternatives Program for Disabled Adults (CAP/DA) unit within NC Medicaid will host an informational webinar on how to become a CAP/DA-qualified direct service provider. Becoming qualified will enable providers to render one or more of the CAP/DA services listed below* or other approved Medicaid services for a CAP/DA beneficiary.
Billing Update for NC Medicaid Policy 1A-5 Child Medical Evaluation and Addition of CPT 99368
NC Medicaid reimburses qualified providers for child medical evaluation and medical team conference services according to guidelines set forth in NC Medicaid policy 1A-5 Child Medical Evaluation and Medical Team Conference for Child Maltreatment.
Lefamulin injection, for intravenous use (Xenleta™) HCPCS code J3490 - Unclassified drugs: Billing Guidelines
Effective with date of service Aug. 22, 2019, the North Carolina Medicaid and NC Health Choice programs cover lefamulin injection, for intravenous use (Xenleta) for use in the Physician Administered Drug Program when billed with HCPCS code J3490 - Unclassified drugs.
NC Medicaid Electronic Health Record Incentive Program
The NC Medicaid Electronic Health Record Incentive Payment System is only accepting Program Year 2019 Stage 3 Meaningful Use attestations.
Community Support Team Service Update
The Medicaid State Plan Amendment was approved by the Centers for Medicare & Medicaid Services with an effective date of Oct. 1, 2019. The clinical coverage policy was posted on Oct. 10, 2019 for an additional 15-day public comment period. Following the 15-day public comment period, the final Community Support Team policy will be posted with an effective date of Nov. 1, 2019.
Peer Support Services State Plan Amendment and Policy Update
The NC Medicaid State Plan Amendment for Peer Support Services was approved by the Centers for Medicare & Medicaid Services on Oct. 23, 2019, with an effective date of July 1, 2019. The clinical coverage policy will be posted with an effective date of Nov. 1, 2019.
Clinical Coverage Policies
A new or amended clinical coverage policy regarding facility-based crisis management for children and adolescents is available on NC Medicaid’s website.
Medicaid Bulletin Monthly Digest
Articles beginning January 2018 are available in the blog format.
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