The following new or amended Medicaid and NC Health Choice clinical coverage policies were posted since Aug. 31, 2018.
Medicaid Bulletin
Medicaid Bulletin Monthly Digest
Articles beginning January 2018 are available in the blog format.
Claims for balloon sinus ostial dilation billed with modifier 50 (bilateral) have been resulting in an underpayment to providers. The issue has been resolved.
If a provider’s enrollment application or Manage Change Request (MCR) does not contain errors, it will process more quickly. NC Medicaid and the NCTracks Enrollment Team frequently share information about commons errors that cause delays in processing applications and MCRs.
North Carolina health care providers are required by law to connect with NC HealthConnex, North Carolina’s designated health information exchange.
Effective with date of service Sept. 5, 2018, the Medicaid and NC Health Choice programs cover antihemophilic factor (recombinant) PEGylated-aucl, for intravenous use (Jivi) for use in the Physician's Drug Program (PDP) when billed with HCPCS code J7199-Hemophilia clotting factor, not otherwise classified.
NC Medicaid and Health Choice will reimburse providers for medically necessary drugs and services and equipment and supplies provided during the Hurricane Florence emergency without prior approval from Sept. 14 through Oct. 5, 2018.
Residents in 27 counties impacted by Hurricane Florence can apply for help buying food through the Disaster Supplemental Nutrition Assistance Program, or "D-SNAP."
NC Medicaid Flexibilities due to Hurricane Florence Extended through Sept. 28, 2018
Per the Sept. 12, 2018, South Carolina Department of Health and Human Services (SCDHHS) Medicaid Bulletin, SCDHHS will, in good faith, reimburse North Carolina qualified providers not currently enrolled with or otherwise pre-approved by the South Carolina Medicaid program for medically necessary and time-sensitive services rendered to South Carolina Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries.
Facility providers can access Sterilization Consent Form status including denial reasons, on the secure NCTracks Provider Portal, if the sterilization consent form has been properly completed.