Medicaid Bulletin
Medicaid Bulletin Monthly Digest
Bulletins published prior to January 2019
Articles since January 2018 are available in the blog format below.
Update to Reimbursement of Long Acting Reversible Contraceptives (LARCs)
Effective for dates of service on or after Oct. 1, 2018, the following DRG classifications specific to LARCs will be added to the current Grouper 36 version within NCTracks for claims reimbursement.
ICD-10 Update for 2019
The 2019 ICD-10 update is effective Oct. 1, 2018 through Sept. 30, 2019, for provider use.
Updates to the NC Medicaid Electronic Health Record (EHR) Incentive Program
Per the updated IPPS Final Rule released Aug. 2, 2018, the EHR reporting period will now be referred to as the Promoting Interoperability (PI) reporting period.
Pre-Admission Screening and Resident Review (PASRR) Program Update
The Department of Health and Human Services is implementing the Referral Screening Verification Process for individuals being considered for admission to an Adult Care Home effective Nov. 1, 2018.
Balloon Ostial Dilation (BOD) Services Billed with Modifier 50 (Bilateral)
Claims for balloon sinus ostial dilation billed with modifier 50 (bilateral) have been resulting in an underpayment to providers. The issue has been resolved.
NCTracks Provider Training Available in October 2018
Registration is open for several instructor-led training courses for providers that will be held in October 2018.
NC Medicaid Flexibilities due to Hurricane Florence end today
Providers are reminded that NC Medicaid flexibilities due to Hurricane Florence end on Oct. 5, 2018.
Regional Provider Training
Personal Care Services (PCS) regional training sessions will be held Oct. 18-Nov. 1, 2018.
Antihemophilic Factor (recombinant) PEGylated-aucl, for Intravenous use (Jivi®) HCPCS Code J7199: Billing Guidelines
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.
Reminder: Changes to the Recredentialing Process
In April 2018, the recredentialing notification and suspension process was modified. The previous rule to extend the recredentialing due date if a Manage Change Request Application is "In Review" has been removed.
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