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.
Medicaid Bulletin
Medicaid Bulletin Monthly Digest
Articles beginning January 2018 are available in the blog format.
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.
Fingerprinting is only required for high-risk providers as identified by 42 CFR 424.518(c), NC General Statute 108C-3g and Session Law 2018-5 SB99.
A list of providers scheduled for re-credentialing in 2018 is available on the Provider Enrollment Page of the North Carolina Medicaid website under the "Re-credentialing" header.
Federal regulation 42 CFR 455.450 requires a state Medicaid agency to screen all initial provider applications based on a categorical risk level.