Effective with date of service Sept. 5, 2018, the Medicaid and NC Health Choice programs cover patisiran lipid complex injection, for intravenous use (Onpattro) for use in the Physicians Drug Program (PDP) when billed with HCPCS code J3490 - Unclassified drugs.
Medicaid Bulletin
Medicaid Bulletin Monthly Digest
Articles beginning January 2018 are available in the blog format.
Registration is open for several instructor-led training courses for providers that will be held in October 2018.
Providers are reminded that NC Medicaid flexibilities due to Hurricane Florence end on Oct. 5, 2018.
The 2019 ICD-10 update is effective Oct. 1, 2018 through Sept. 30, 2019, for provider use.
The following new or amended Medicaid and NC Health Choice clinical coverage policies were posted since Aug. 31, 2018.
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.