Medicaid Bulletin
Behavioral Health Policy Update
Amended policies will post to the NC Medicaid Clinical Coverage Policies website with an effective date of Oct. 1, 2020.
Tafasitamab-cxix for Injection, for Intravenous Use (Monjuvi®) HCPCS Code J9999: Billing Guidelines
Effective with date of service Aug. 13, 2020, the Medicaid and NC Health Choice programs cover tafasitamab-cxix for injection, for intravenous use (Monjuvi®) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.
SPECIAL BULLETIN COVID-19 #135: Expectation to Comply with Infection Control and Prevention Measures
Strong infection prevention and control practices are critical to reducing the transmission of COVID-19 within long-term care facilities. NC DHHS is reiterating its expectation that providers participate in the infection prevention and control activities.
SPECIAL BULLETIN COVID-19 #134: Clarification of COVID-19 Temporary Rate Increases and Clinical Policy Changes
This bulletin replaces SPECIAL BULLETIN COVID-19 #119 in its entirety.
SPECIAL BULLETIN COVID-19 #133: COVID-19 Exposure Notification App Available
The North Carolina Department of Health and Human Services announced the launch of a COVID-19 Exposure Notification app called SlowCOVIDNC. The app will help North Carolinians slow the spread of the virus by alerting them when they may have been exposed to someone who has tested positive for COVID-19.
Public Comment Period for Community Alternatives Program for Children Waiver Renewal
To begin the preparation for the renewing of the CAP/C waiver, NC Medicaid is soliciting comments, recommendations, and suggestions in the areas of access, flexibilities of home and community-based services, and operational efficiencies. An open public comment period begins Sept. 22, 2020.
Inebilizumab-cdon Injection, for Intravenous Use (Uplizna™) HCPCS Code J3590: Billing Guidelines
Effective with date of service July 27, 2020, the Medicaid and NC Health Choice programs cover inebilizumab-cdon injection, for intravenous use (Uplizna™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3590 - Unclassified biologics.
Community Alternatives Program Internal Independent Assessment
To ensure the waiver enrollment administrative processes are executed as approved in each waiver application, until the award of a contract to an external CIAE vendor, NC Medicaid will implement an internal independent assessment review process. This internal independent assessment process will begin in October 2020 with a go-live date of Oct. 19, 2020.
Billing Code Update for Nurse Practitioners and Physician Assistants
North Carolina Medicaid has received calls concerning claim denials for some services provided by nurse practitioners (NPs) and physician assistants (PAs).
SPECIAL BULLETIN COVID-19 #132: Laboratory Codes for Coronavirus (COVID-19) Testing
CMS and the American Medical Association have released a CPT code for an antigen test designed to detect proteins from the virus that causes COVID-19 in respiratory specimens. NC Medicaid is adding this CPT code to NCTracks for medically necessary laboratory testing effective Sept. 1, 2020.
Medicaid Bulletin Monthly Digest
Articles beginning January 2018 are available in the blog format.
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