Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Bulletins published prior to January 2019

Articles since January 2018 are available in the blog format below.

Endoscopy Code Families Updated in NCTracks

Friday, February 1, 2019

NC Medicaid has completed updating endoscopy codes in NCTracks, aligning base codes with related procedures in the same family as well as creating three new endoscopy families in NCTracks.

New Rules for Abandoned Applications in NCTracks

Friday, February 1, 2019

Effective Jan. 27, 2019, abandoned applications are subject to new rules in NCTracks. While the process for addressing incomplete applications will not change, the timeframes allowed for the submission of documentation are revised.

Clarification on Billing for Long Acting Reversible Contraceptives (LARCs)

Thursday, January 24, 2019

For clarification purposes of information communicated in October 2018 Medicaid Bulletin, please note that effective Oct.

Centralized Credentialing Vendor Selected for NC Medicaid

Thursday, January 10, 2019

A contract has been awarded to Wipro Infocrossing to serve as the Provider Data Contractor (PDC), as NC Medicaid transitions to Managed Care.

Allergy Immunotherapy 1N-2

Wednesday, January 9, 2019

Clinical Coverage Policy 1N-2, Allergy Immunotherapy has been revised effective Jan. 1, 2019, to reflect changes in unit dosing.

Risperidone for extended-release injectable suspension, for subcutaneous use (Perseris™) HCPCS code J3490: Billing Guidelines

Wednesday, January 9, 2019

Effective with date of service Nov. 19, 2018, the NC Medicaid and Health Choice programs cover risperidone for extended-release injectable suspension, for subcutaneous use (Perseris™) for use in the Physician Administered Drug Program when billed with HCPCS code J3490 - Unclassified drugs.

CPT Code Update 2019

Wednesday, January 9, 2019

Effective with date of service Jan. 1, 2019, the American Medical Association has added new CPT codes, deleted others and changed descriptions of some existing codes. For complete information regarding all CPT codes and descriptions, refer to the 2019 edition of Current Procedural Terminology, published by the AMA. 

Clinical Coverage Policies

Wednesday, January 9, 2019

The following new or amended clinical coverage policies are available on NC Medicaid’s clinical coverage policies web page:

Elapegademase-lvlr injection, for intramuscular use (Revcovi™) HCPCS code J3590: Billing Guidelines

Wednesday, January 9, 2019

Effective with date of service Nov. 28, 2018, the NC Medicaid and Health Choice programs cover elapegademase-lvlr injection, for intramuscular use (Revcovi™) for use in the Physician Administered Drug Program when billed with HCPCS code J3590 - Unclassified biologics.

Crotalidae Immune f(ab’)2 (equine), lyophilized powder for solution for injection for intravenous use (Anavip®) HCPCS code J3590: Billing Guidelines

Wednesday, January 9, 2019

Effective with date of service Nov. 2, 2018, the NC Medicaid and Health Choice programs cover crotalidae immune f(ab’)2 (equine), lyophilized powder for solution for injection for intravenous use (Anavip®) for use in the Physician Administered Drug Program when billed with HCPCS code J3590 - Unclassified biologics.

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