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Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Bulletins published prior to January 2019

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

Clinical Coverage Policies

Friday, August 3, 2018

The following new or amended combined North Carolina Medicaid and NC Health Choice clinical coverage policies are available on Medicaid’s website:

Re-credentialing and Ongoing Verification Updates

Friday, August 3, 2018

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.

NCTracks Provider Training Available in August 2018

Friday, August 3, 2018

Registration is open for the August 2018 instructor-led provider training courses listed below. Slots are limited.

Pre-Admission Screening and Resident Review (PASRR) Program Update

Friday, August 3, 2018

Beginning Sept.1, 2018, adult care home and nursing home Pre-Admission Screening and Resident Review (PASRR) submissions through Provider Link will no longer be accepted.

Avoid Delays in the Processing of Provider Enrollment Applications

Friday, August 3, 2018

If a provider’s enrollment application or Manage Change Request (MCR) does not contain errors, it will process more quickly. The NCTracks Enrollment Team identified commons errors that cause delays in processing applications and MCRs.

Update to Acute Inpatient Hospital Services Clinical Policy 2A-1

Friday, August 3, 2018

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.

Coverage for CPT Code 95012: Fractional Exhaled Nitric Oxide (FENO) Measurement

Monday, July 2, 2018

Effective July 1, 2018, CPT Code 95012, Fractional Exhaled Nitric Oxide (FENO) measurement, is approved in the assessment of pediatric beneficiaries with suspicion of asthma and for asthma management.

Update - Avoid Delays in the Processing of Provider Enrollment Applications

Monday, July 2, 2018

If a provider’s enrollment application or Manage Change Request does not contain errors, it will process more quickly. The NCTracks Enrollment Team identified commons errors that cause delays in processing applications and MCRs.

Laboratory Rate Updates – Effective July 1, 2018

Monday, July 2, 2018

In accordance with the NC State Plan, Section 4.19-B, Section 3, Page 1, North Carolina Division of Medical Assistance (DMA) will revise rates for the following laboratory procedure codes: 81220, 81221, 81222, 81223, 81228, 81229, 81243, 81244, 81331, and 81507.

NC Medicaid and N.C. Health Choice Preferred Drug List Changes

Monday, July 2, 2018

Effective Aug. 1, 2018, North Carolina Medicaid will make a change to the N.C. Medicaid and N.C. Health Choice Preferred Drug List in the Antihyperkinesis/Attention Deficit Hyperactivity Disorder (ADHD) class.

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