Medicaid Bulletin

On April 2, 2018, General Dynamics Information Technology acquired CSRA Inc. CSRA is now "CSRA State and Local Solutions LLC, A General Dynamics Information Technology Company," or simply "GDIT."

In response to provider requests and to allow reimbursement for behavioral health integration in primary care settings, North Carolina Medicaid is adding coverage for the following evaluation and management codes effective October 1, 2018.

Family Planning Medicaid provides limited coverage to beneficiaries with MAFDN eligibility.

The following CPT codes should not be billed with a separate office visit. An office visit component is included in reimbursement for these CPT codes.

Sterilization claims must be submitted with ICD-10-CM diagnosis Z30.2 (encounter for sterilization) as the primary or secondary diagnosis code on the claim.

Medicaid has provided instructions to NCTracks on updating the claims processing system. The following procedure code list has been updated recently to include additional NP and PA taxonomies.

It has come to NC Medicaid’s attention that claims for balloon sinus ostial dilation billed with modifier 50 (bilateral), were resulting in an under payment to providers. The issue has been resolved.

The North Carolina Department of Health and Human Services developed the Advanced Medical Home program as the primary vehicle for delivering local care management as the state transitions to Medicaid managed care.

NC-MIPS is accepting Program Year 2018 Modified Stage 2 and Stage 3 MU attestations.

Medicaid has been made aware of reimbursement delays when claims for medical services are billed for inpatient services with a psychiatric diagnosis as the primary diagnosis.