Clinical Coverage Policy 11A-15, Hematopoietic Stem-Cell Transplantation for Solid Tumors of Childhood, has been revised.
Medicaid Bulletin
Medicaid Bulletin Monthly Digest
Articles beginning January 2018 are available in the blog format.
Effective July 1, 2018, North Carolina Medicaid has revised Clinical Coverage Policy (CCP) 1-O-3, Keloid Excision and Scar Revision, to clarify the procedure for proper submission of preoperative photographs to CSRA as part of the prior approval process.
Centers for Medicare & Medicaid Services (CMS) is overhauling and streamlining the Electronic Health Record (EHR) Incentive Program. The goal is to move the program beyond requirements for meaningful use (MU) to increase focus on interoperability and improving patient access to health information.
On June 1, 2018, hospitals, physicians, physician assistants and nurse practitioners with an electronic health record system must have initiated a connection to NC HealthConnex, North Carolina’s designated statewide health information exchange network.
Effective with date of service April 1, 2018, the North Carolina Medicaid and N.C. Health Choice (NCHC) programs cover ibalizumab-uiyk injection, for intravenous use (Trogarzo) for use in the Physician’s Drug Program (PDP) when billed with HCPCS code J3590 - Unclassified biologics.
The following new or amended combined North Carolina Medicaid and NC Health Choice clinical coverage policies are available on Medicaid’s Clinical Coverage Policy web pages.
The procedure code list for nurse practitioners (NPs) and physician assistants (PAs) has been updated recently to include additional NP and PA taxonomies.
Effective July 1, 2018, North Carolina Medicaid and NC Health Choice behavioral health providers who were added to NCTracks via the Local Management Entity/Managed Care Organization Provider Upload process must complete reverification. Providers identified are being notified of their reverification due date via NCTracks communication to the Office Administrator on record.
This announcement is to inform Community Alternatives Program for Children providers of revisions to the technical changes in Clinical Coverage Policy, 3K-1, Community Alternatives Program for Children (CAP/C).
In response to provider comments and questions regarding billing under the new federal Ordering, Prescribing and Referring (OPR) rules, North Carolina Medicaid is issuing this clarification for radiology and Independent Diagnostic Testing Facilities (IDTF).