August 2002 Medicaid Bulletin title image
 

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In This Issue..

All Providers:

Ambulatory Surgical Center Providers:

CAP Case Managers:

Carolina ACCESS Providers:

Dental Providers:

Durable Medical Equipment Providers:

Federally Qualified Health Centers:

Health Departments:

Home Health Providers:

Hospitals:

Maternity Services Providers:

Nurse Midwives:

Nurse Practitioners:

Outpatient Specialized Therapy Providers:

Physicians:

Prescribers and Pharmacists:

Private Duty Nursing Providers:

Psychiatric Residential Treatment Facility Providers:

Rural Health Clinics:


Attention: Rural Health Clinics and Federally Qualified Health Centers

Core Service Code Conversion - Correction to End-Dated Code

This article is being reprinted to correct the end-dated code listed for Federally Qualified Health Center (FQHC) core services published in the June 2002 Medicaid bulletin. The correct end-dated code is Y2089.

Effective with date of service June 30, 2002, state-created codes Y2058 and Y2089 will be end-dated to comply with the implementation of national procedure codes mandated by the Health Insurance Portability and Accountability Act (HIPAA).

Effective with date of service July 1, 2002, Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) providers must bill procedure code T1015 - Clinic visit/encounter, all inclusive -for all core services. An RHC/FQHC core service visit must be billed using the provider's six-digit provider number with alpha suffix "A."
 

End-dated Code New Code
Y2058 - RHC Core Service  T1015 - Clinic visit/encounter, all inclusive 
Y2089 - FQHC Core Service  T1015 - Clinic visit/encounter, all inclusive 

EDS, 1-800-688-6696 or 919-851-8888


Attention: All Providers

Drug Coverage for Impotence Drugs

Effective, July 1, 2002, impotence drugs for males age 25 and over will no longer require prior approval. The limit of two units per month remains in effect. Physicians must continue to document the medical necessity for these impotence drugs by writing "erectile dysfunction" in their own handwriting on the face of the prescription.

For males under the age of 25, the physician (or designee) must call 919-857-4037 to obtain a prior approval form. The physician must complete the requested information for medical necessity and return the completed form to the following address:

N.C. Division of Medical Assistance
Attn: Sharman Leinwand, MPH, R.Ph.
2511 Mail Service Center
Raleigh, North Carolina 27699-2511

FAX: 919-733-2796

An authorization code will be assigned to all requests that are approved. This code must be included on the prescription to notify the pharmacist that the prescription has been approved for dispensing. Claims for prescriptions dispensed to recipients under the age of 25 must be submitted on paper and not through Point of Sale.
 

EDS, 1-800-688-6696 or 919-851-8888


Attention: All Providers

Proposed Medical Coverage Policies

In accordance with Session Law 2001-424, Senate Bill 1005, proposed new or amended Medicaid medical coverage policies are available for review and comment on DMA's website. To submit a comment related to a policy, refer to the instructions on the website. Providers without internet access can submit written comments to the address listed below.

Darlene Cagle
Medical Policy Section
Division of Medical Assistance
2511 Mail Service Center
Raleigh, NC 27699-2511

The initial comment period for each proposed policy is 45 days. An additional 15-day comment period will follow if a proposed policy is revised as a result of the initial comment period.
 

Darlene Cagle, Medical Policy Section
DMA, 919-857-4020


Attention: All Providers

Modifier 76 and 77 and Laboratory Codes

The following codes have the description of "each, every or per" in the CPT descriptor. Modifiers 76 and 77 have been removed from these codes to allow for billing of separate analytes.
 
82016 
82017 
82042 
82127 
82128 
82131 
82136 
82139 
82172 
82190 
82261 
82379 
82492 
82657 
82658 
82784 
82787 
82926 
82928 
82952 
83018 
83080 
82788 
83789 
83883 
83896 
83898 
83901 
83903 
83904 
83905 
83906 
83918 
83919 
84150 
84182 
84376 
84377 
84378 
84379 
86000 
86001 
86003 
86146 
86147 
86160 
86161 
86171 
86185 
86235 
86255 
86256 
86331 
86403 
86406 
86586 
86850 
86870 
86880 
86885 
86886 
86903 
86904 
86911 
86920 
86921 
86922 
86927 
86930 
86931 
86932 
86940 
86945 
86970 
86971 
86972 
86975 
86976 
86977 
86978 
86985 
87046 
87076 
87077 
87106 
87118 
87140 
87147 
87181 
87184 
87185 
87186 
87187 
87188 
87190 
87253 
87254 
87274 
87300 
87449 
87450 
87451 
87797 
87798 
87799 
88240 
88241 
88271 
88280 
88285 
88300 
88302 

EDS, 1-800-688-6696 or 919-851-8888


Attention: All Providers

Health Insurance Portability and Accountability Act Update

The N.C. Medicaid program plans to implement the following HIPAA-related transactions in October 2002: Trading partner testing is scheduled to begin in September 2002 for these three transactions. Please contact the Electronic Commerce Services (ECS) Unit at EDS for testing information after August 15, 2002, by calling 1-800-688-6696 or 919-851-8888. In lieu of testing directly with N.C. Medicaid, providers may test with a third party certification agency. Once certification information is on file with N.C. Medicaid, providers will have the capability to begin submitting and receiving HIPAA-compliant transactions, beginning in October 2002.

For more information regarding third party certification, please refer to the WEDI/SNIP Testing and Certification white paper at http://snip.wedi.org. Additional information on third party certification and remaining transaction implementation and testing dates will be provided in future Medicaid bulletinsand on DMA's HIPAA website.
 

EDS, 1-800-688-6696 or 919-851-8888


Attention: All Providers

Sodium Hyaluronate for Intra-Articular Injection - Billing Guidelines

The N.C. Medicaid program will end-date the current code for Sodium Hyaluronate to align with Medicare guidelines. Effective with date of service September 30, 2002, HCPCS code J7316 (Sodium hyaluronate 5 mg, for intra-articular injection) will be end-dated. Effective with date of service October 1, 2002, providers must bill Q3030 (Sodium hyaluronate, per 20 to 25 mg dose, for intra-articular injection). Providers must indicate the number of units given in block 24G on the CMS-1500 claim form and bill their usual and customary charge.
 

EDS, 1-800-688-6696 or 919-851-8888


Attention: All Providers

Billing of Radiopharmaceuticals and Pharmaceutical Stress Agents for Myocardial Perfusion Testing

When billing for radiopharmaceutical and pharmacological stress agents used in myocardial perfusion diagnostic procedures use the following as a billing guideline.
 
Radioactive Imaging Agent Code Pricing
Technetium TC 99M Sestamibi (Cardiolite)  A9500  Invoice 
Thallous Chloride TL201  A9505  Invoice 
Supply of radiopharmaceutical diagnostic imaging agent,
not otherwise classified such as Tetrofosim (Myoview) 
78990  Invoice 

The invoice must be attached and include the:

Invoices submitted without this information will be denied.
 
Pharmacological Stress Agents Code Pricing
Dipyridamole (Persantine), per 10 mg.  J1245  Fee schedule 
Dobutamine (Dobutrex), per 250 mg.  J1250  Fee schedule 
Adenosine (Adenoscan), per 90 mg.  J0151  Fee schedule 

EDS, 1-800-688-6696 or 919-851-8888


Attention: All Providers

Electronic Data Interchange Update

Medicaid recipient eligibility verification is available to North Carolina Medicaid providers through Electronic Data Interchange (EDI) vendor networks. The provider staff can make inquiries for recipient Medicaid eligibility status from their office computer through the EDI vendor. Providers who wish to use this option must contract directly with an approved EDI vendor for software and network access. The following are North Carolina EDI vendors approved as of June 2002.

WebMD Corporation (formerly Envoy)
15 Century Blvd., Suite 600
Nashville, TN 37214
1-800-366-5716 (marketing)
www.webmd.com

MedifaxEDI
1283 Murfreesboro Rd
Nashville, TN 37217-2421
1-800-819-5003 (marketing)
marketing@medifax.com

Healthcare Data Exchange Corporation (HDX)
300 Lindenwood Dr., Suite 200
Malvern, PA 19355-1751
1-610-219-1859 (marketing, Brian Gill)
brian.gill@hdx.com

Passport Health Communications, Inc.
720 Cool Springs Blvd., Suite 450
Franklin, TN 37067
1-888-661-5657 (marketing, Lloyd Baker)
Lloyd.baker@passporthealth.com

Providers interested in subscribing for EDI services are encouraged to contact the above vendors. Updated lists will be published in the general Medicaid bulletin as new vendors are approved and enrolled.
 

Susan Ryan, Recipient and Provider Services
DMA, 919-857-4019


Attention: All Providers

Injectable Drugs in the Physician's Drug Program - Code Conversion Update

Effective with date of service July 1, 2002, state-created codes for drugs in the Physician's Drug Program were end-dated and replaced with national codes. Some temporary codes or CPT codes have also been replaced with HCPCS J, P or S codes. The chart below indicates the codes that have been replaced.

An invoice is required for those drugs that are billed with J3490. The invoice must include the name of the Medicaid recipient, the Medicaid identification (MID) number, the name of the medication, the dosage given, the National Drug Code (NDC) number from the vial(s) used, the number of vials used per NDC code, and the cost per dose. The NDC number is printed on each drug product.
 
Old Code
New Code
Description of Replacement Code
Q0156 
P9041 
Albumin (human), 5%, 50 ml** 
Q0157 
P9047 
Albumin (human), 25%, 50 ml 
J2996 
J2997 
Alteplase Recombinant, 1 mg** 
W5181 
S0016 
Amikacin Sulfate, 500 mg 
W5156 
Q0144 
Azithromycin, oral suspension 1 unit = 1 gm packet (Zithromax) 
90586 
J9031 
BCG live (intravesical), per installation 
W5170 
J3490* 
Baclofen Kit, 2 5 ml Ampules 
W5169 
J3490* 
Baclofen Kit, 4 5 ml Ampules 
X1270 
S0009 
Butorphanol Tartrate, 1 mg (Stadol) 
W5185 
J0692 
Cefepime HCL, 500 mg 
W5176 
S0023 
Cimetadine HCL, 300 mg 
W5183 
J0744 
Ciprofloxacin for intravenous infusion, 200 mg 
W5195 
J9160 
Denileukin Diftitox, 300 mcg (Ontak) 
Q0160 
J7193 
Factor IX (antihemophilic factor, purified, non-recombinant), per I.U. 
Q0161 
J7195 
Factor IX (antihemophilic factor, recombinant), per I.U. 
W5127 
J3490* 
Lupron Depot Pediatric, 7.5 mg 
W5128 
J3490* 
Lupron Depot Pediatric, 11.25 mg 
W5129 
J3490* 
Lupron Depot Pediatric, 15 mg 
W5198 
S0079 
Octreotide Acetate, 100 mcg (Sandostatin)** 
J2352 
J3490 
Octreotide Acetate, 1mg (Sandostatin). Pricing based on 20 mg** 
J2352 
J3490 
Octreotide Acetate, 1mg (Sandostatin). Pricing based on 10 mg** 
W5192 
S0080 
Pentamidine Isethionate, 300 mg 
J2994 
J2993 
Reteplase, 18.1 mg (Retavase)** 
Y1856 
J3490* 
Sodium Bicarbonate 7.5% up to 50 ml 
J7315 
J7316 
Sodium Hyaluronate, 5 mg for intra-articular injection** 

* Indicates that an invoice is required with the claim.

** Indicates a description change.
 

End-dated Codes for Injectable Drugs

The following codes will be end-dated from the Physician's Drug Program effective with date of service September 30, 2002. Vaccine codes are being end-dated in accordance with information obtained from the drug manufacturers and the Centers for Disease Control. These vaccines are no longer manufactured or available in the United States or are no longer recommended.

Injectable Drugs
 
Code
Description of End-Dated Codes
J0510 
Benzquinamide HCl, up to 50 mg 
J0190 
Biperiden, 5 mg (Akineton) 
J0695 
Cefonicid Sodium, 1 gm 
J0730 
Chlorpheniramine Maleate, per 10 mg 
J3080 
Chlorprothixene, up to 50 mg 
J0810 
Cortisone, up to 50 mg 
J2480 
Hydrochlorides of Opium Alkaloids (Pantopan) 
J1739 
Hydroxyprogesterone Caproate, 125 mg/ml 
J1741 
Hydroxyprogesterone Caproate, 250 mg/ml 
J3270 
Imipramine HCl, up to 25 mg 
W5128 
Lupron Depot Pediatric, 11.25 mg 
W5129 
Lupron Depot Pediatric, 15 mg 
J3450 
Mephentermine, up to 30 mg 
J2970 
Methicillin Sodium, up to 1 gm (Staphcillin) 
J1970 
Methotrimeprazine, up to 20 mg 
J3390 
Methoxamine, up to 20 mg (Basoxyl) 
J0340 
Nandrolone Phenpropionate, up to 50 mg (Duradolin) 
J2640 
Prednisolone Sodium Phosphate, up to 20 mg 
J1690 
Prendisolone Terbutate, up to 20 mg 
J2675 
Progesterone, per 50 mg 
J1930 
Propiomazine HCl, up to 20 mg 
J2330 
Thiothixene, up to 4 mg (Navane) 
J0400 
Trimethapan Camsylate, up to 500 mg 

Vaccines/Toxoids
 
Code
Description of End-Dated Codes
90646 
Hemophilus influenza b vaccine (Hib), PRP-D conjugate, for booster use only, for intramuscular use
90659 
Influenza virus vaccine, whole virus, for intramuscular or jet injection use
90676 
Rabies vaccine, for intradermal use
90701 
Diptheria, tetanus toxoids, and whole cell pertussis vaccine (DTP), for intramuscular use
90708 
Measles and rubella virus vaccine, live for subcutaneous or jet injection use
90709 
Rubella and mumps virus vaccine, live, for subcutaneous use
90712 
Poliovirus vaccine, (any type(s) (OPV), live, for oral use
90719 
Diphtheria toxoid, for intramuscular use
90720 
Diphtheria, tetanus toxoids, and whole cell pertussis vaccine and Hemophilus influenza B vaccine (DTP-Hib), for intramuscular use
90725 
Cholera vaccine for injectable use

EDS, 1-800-688-6696 or 919-851-8888


Attention: All Providers

Injectable Drugs

The following FDA-approved drugs, immune globulins, and vaccines/toxoids should be added to the list published in the June 2002 general Medicaid bulletin. This completes the list of injectable drugs covered by the N.C. Medicaid program when provided in a physician's office for the FDA-approved indications. Fees are effective with date of service July 1, 2002.

Physicians will continue to bill on the CMS-1500 claim form using the appropriate drug code, indicating the number of units administered as specified in the listing. Free vaccines from the Vaccines for Children (VFC) program are not included in this list.

New Codes
 
Old Code
New Code
Description
Fee
Q0156 
P9041 
Albumin (human), 5%, 50 ml 
$ 26.28 
Q0157 
P9047 
Albumin (human), 25%, 50 ml 
88.65 
J2996 
J2997 
Alteplase recombinant, 1 mg** 
24.82 
J2994 
J2993 
Reteplase, 18.1 mg (Retavase)** 
1,240.94 

** Indicates a description change.

Immune Globulins
 
Code
Description
Fee
90283 
Immune globulin (IgIV), human, for intravenous use, 500 mg
$ 42.84 
90291 
Cytomegalovirus immune globulin (CMV-IgIV), human, for intravenous use, 1 ml
13.31 
90371 
Hepatitis B immune globulin (HBIg), human, for intramuscular use, 0.5 ml
68.04 
90375 
Rabies immune globulin (RIg), human, for intramuscular and/or subcutaneous use, 2 ml
151.20 
90376 
Rabies immune globulin, heart-treated (RIg-HT), human, for intramuscular and/or subcutaneous use, 2 ml
143.68 
90379 
Respiratory syncytial virus immune globulin (RSV-IgIV), human, for intravenous use, 1 ml
15.47 
90384 
Rho(D) immune globulin (RhIg), human, full-dose, for intramuscular use, 1500 IU/300 mcg
99.90 
90385 
Rho(D) immune globulin (RhIg), human, mini-dose, for intramuscular use, 120 IU/50 mcg 
34.02 
90386 
Rho(D) immune globulin (RhIglV), human, for intravenous use, 100 IU
20.38 
90389 
Tetanus immune globulin (TIg), human, for intramuscular use, 250 u/1 ml
108.00 
90396 
Varicella-zoster immune globulin, human, for intramuscular use, 125 u/1.25 ml
112.50 
J1460 
Gamma Globulin, Intramuscular, 1 cc (Gammar) 
3.24 
J1470 
Gamma Globulin, Intramuscular, 2 cc 
6.48 
J1480 
Gamma Globulin, Intramuscular, 3 cc 
9.72 
J1490 
Gamma Globulin, Intramuscular, 4 cc 
12.96 
J1500 
Gamma Globulin, Intramuscular, 5 cc 
16.20 
J1510 
Gamma Globulin, Intramuscular, 6 cc 
19.44 
J1520 
Gamma Globulin, Intramuscular, 7 cc 
22.68 
J1530 
Gamma Globulin, Intramuscular, 8 cc 
25.92 
J1540 
Gamma Globulin, Intramuscular, 9 cc 
29.16 
J1550 
Gamma Globulin, Intramuscular, 10 cc 
32.40 
J1560 
Gamma Globulin, Intramuscular, over 10 cc (use correct combinations of services) 
^^

^^ Designates special pricing.

Vaccines/Toxoids
 
Code
Description
Fee
90585 
Bacillus Calmette-Guerin vaccine (BCG), for tuberculosis, live, for percutaneous use, per vial
$ 151.50 
90632 
Hepatitis A vaccine, adult dosage, for intramuscular use, 1 ml 
57.83 
90633 
Hepatitis A vaccine, pediatric/adolescent dosage-2 dose schedule, for intramuscular use, 0.5 ml
29.52 
90645 
Hemophilus influenza b vaccine (Hib), Hb0C conjugate (4 dose schedule), for intramuscular use, 0.5 ml
25.54 
90647 
Hemophilus influenza b vaccine (Hib) PRP-OMP conjugate (3 Dose schedule), for intramuscular use, 0.5 ml
21.86 
90648 
Hemophilus influenza b vaccine (Hib) PRP-T conjugate (4 dose schedule), for intramuscular use, 0.5 ml
22.58 
90658 
Influenza virus vaccine, split virus, 3 years and above dosage, for intramuscular or jet injection use, 0.5 ml
6.77 
90675 
Rabies vaccine, for intramuscular use, 2 ml 
140.32 
90680 
Rotavirus vaccine, tetravalent, live, for oral use
17.37 
90703 
Tetanus toxoid adsorbed, for intramuscular or jet injection use, 0.5 ml
7.88 
90704 
Mumps virus vaccine, live, for subcutaneous or jet injection use
18.80

per dose 

90705 
Measles virus vaccine, live, for subcutaneous or jet injection use, 0.5 ml
14.94 
90706 
Rubella virus vaccine, live, for subcutaneous or jet injection use, 0.5 ml
15.65 
90707 
Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous or jet injection use
40.75

per dose 

90713 
Poliovirus vaccine, inactivated, (IPV), for subcutaneous use
26.05

per dose 

90716 
Varicella virus vaccine, live, for subcutaneous use, 0.5 ml
61.52 
90704 
Mumps virus vaccine, live, for subcutaneous or jet injection use
18.80

per dose 

90718 
Tetanus and diphtheria toxoids (Td) adsorbed for use in individuals seven years or older, for intramuscular or jet injection, 0.5 ml
10.35 
90721 
Diphtheria, tetanus toxoids, and acellular pertussis vaccine and Hemophilus influenza B vaccine (DtaP-Hib), for intramuscular use
42.30

per dose 

90732 
Pneumococcal polysaccharide vaccine, 23-valent, adult or immunosuppressed patient dosage, for use in individuals 2 years or older, for subcutaneous or intramuscular use, 0.5 ml
12.88 
90733 
Meningococcal polysaccharide vaccine (any group(s)), for subcutaneous or jet injection use, 0.05 mg
$ 72.31 
90746 
Hepatitis B vaccine, adult dosage, for intramuscular use, 1 ml
63.42 
90747 
Hepatitis B vaccine, dialysis or immunosuppressed patient dosage 

(4 dose schedule), for intramuscular use, 40 mcg/2ml

105.38 

Corrections to the Injectable Drug List Update Published in the June 2002 Medicaid Bulletin
 
Old Code
New Code
Description
Fee
W5181 
S0016 
Amikacin Sulfate, 500 mg (Amikin) ** 
$ 30.83 
W5156 
Q0144 
Azithromycin, oral suspension 1 unit = 1 gm packet (Zithromax), only oral drug on list 
20.07 
J1070 
J1070 
Testosterone Cypionate, up to 100 mg ** 
4.10 

** Indicates a description change.

Billing Guidelines When Billing by Invoice for J3490 (Miscellaneous Drug Code)

The following drugs are billed with the miscellaneous drug code, J3490. An invoice must be submitted with the claim when these drugs are billed. The invoice must include the name of the Medicaid recipient, the Medicaid identification (MID) number, the name of the medication, the dosage given, the National Drug Code (NDC) number from the vial(s) used, the number of vials used per NDC code, and the cost per dose. The NDC number is printed on each drug product.
 
Old Code
Old Description
New Code
New Description
W5170 
Baclofen kit, 2 5 ml ampules 
J3490 
Baclofen kit, 2 5 ml ampules 
W5169 
Baclofen kit, 4 5 ml ampules 
J3490 
Baclofen kit, 4 5 ml ampules 
W5127 
Lupron depot pediatric, 7.5 mg 
J3490 
Lupron depot pediatric 7.5 mg, pricing based on 7.5 mg package 
W5128 
Lupron depot pediatric, 11.25 mg 
J3490 
Lupron depot pediatric 11.25 mg, pricing based on 11.25 mg package 
W5129 
Lupron depot pediatric, 15 mg 
J3490 
Lupron depot pediatric 15 mg, pricing based on 15 mg package 
W5198 
Octreotide acetate LAR depot, 1 mg 
J3490 
Octreotide acetate, 1 mg, pricing based on 20 mg (Sandostatin) 
W5198  Octreotide acetate LAR depot, 1 mg 
J3490 
Octreotide acetate, 1 mg, pricing based on 10 mg (Sandostatin) 
Y1856  Sodium bicarbonate 
J3490 
Sodium bicarbonate, 7.5%, up to 50 ml 

EDS, 1-800-688-6696 or 919-851-8888


Attention: All Providers

CPT Code Update for 2002 - Coverage of Additional Codes

Effective with date of service January 1, 2002, N.C. Medicaid providers may bill the four new CPT codes listed in the following table, which replace codes deleted or revised by the American Medical Association (AMA) for 2002. Claims submitted with the deleted code for dates of service on or before March 31, 2002 will continue to be accepted for processing. Claims for dates of service on or after April 1, 2002 must be filed using the 2002 CPT code listed below.

The 2001 CPT description of code 20550 Injection, tendon sheath, ligament, trigger points or ganglion cyst was changed to Injection; tendon sheath, ligament, ganglion cyst in CPT 2002. Three codes were added to 2002 CPT to differentiate the techniques associated with multiple muscle group injections for trigger points and injection of a tendon at the site of origin or insertion.
 
Deleted Code
Revised Code
New Code
Description
 
20550 
20551 
Injection; tendon origin/insertion
 
20550 
20552 
Injection; single or multiple trigger point(s), one or two muscle group(s)
 
20550 
20553 
Injection; single or multiple trigger point(s), three or more muscle group(s)
86683 
 
82274 
Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations

Denied claims related to billing these new codes may be corrected and resubmitted.
 

EDS, 1-800-688-6696 or 919-851-8888


Attention: Health Departments

Conversion of Refugee Health Assessment Code, STD Control Treatment Code, and TB Control Treatment Code

Effective with date of service September 30, 2002, procedure codes Y2034, Y2013, and Y2012 will be end-dated. Health departments will follow new billing guidelines beginning with date of service October 1, 2002. Please refer to the August 2002 Special Bulletin IV, HIPAA Code Conversion, for policy and billing details.
 

EDS, 1-800-688-6696 or 919-851-8888


Attention: Physicians

New Codes for the Oral Screening Preventive Package for Use in Primary Care Physician Offices

Effective with date of service October 1, 2002, procedure codes W8002 and W8003 (Oral Screening Preventive Package) will be end-dated and replaced by American Dental Association (ADA) dental codes to comply with the implementation of national procedure codes mandated by the Health Insurance Portability and Accountability Act (HIPAA).

Procedure code W8002 (Initial Oral Screening) will be replaced with the following procedure codes:
 

Procedure Code Description
D0150  Comprehensive oral evaluation 
D1203  Topical application of fluoride (prophylaxis not included) - child 
D1330  Oral hygiene instructions 

 

The following criteria apply for the Initial Oral Screening:

Procedure code W8003 (Periodic Oral Screening) will be replaced with the following procedure codes:
 
Procedure Code Description
D0120  Periodic oral evaluation 
D1203  Topical application of fluoride (prophylaxis not included) - child 
D1330  Oral hygiene instructions 

The following criteria still apply for the Periodic Oral Screening:

Claims Filing Process

Prior approval is not required for these services. These services are billed on the CMS-1500 claim form or electronically through ECS. Refer to the claim examples listed below. Refer to the Basic Medicaid handout for additional billing instructions.

Claim Example 1:  Periodic Oral Screening as a Separate Procedure
Claim Example 2:  Initial oral Screening in Conjunction with an Office Visit
Claim Example 3:  Initial Oral Screening in Conjunction with a Health Check Screening

For health departments, these services are billed through HSIS. Refer to the HSIS screen entry examples.

Note: Medicaid will only allow reimbursement of these ADA codes if all three procedures are billed on the same claim for the same date of service.

Note: These procedure codes all begin with an alpha "D" character followed by four numeric characters.
 

EDS, 1-800-688-6696 or 919-851-8888


Attention: Prescribers

Valid DEA Numbers Required on Pharmacy Prescriptions

The Division of Medical Assistance (DMA) requires DEA numbers on all recipient pharmacy claims. Providers must have their DEA registration number on file. Failure to do so may result in denied claims. If a prescriber does not have a DEA number and needs to issue prescriptions to Medicaid recipients, the prescriber should contact Brenda Scott in the DUR Section at 919-733-3590.

A prescriber Medicaid identification number (ID) will be issued in lieu of the DEA number. The ID number follows the same format as the DEA number and will always begin with a Z (for example, ZF1234567).

Prescribers must enter this number on their Medicaid prescriptions. This number is referred to as a PRESCRIBER MEDICAID IDENTIFICATION NUMBER only, and should not be referred to as a DEA number.

If updated information has not been submitted to EDS Provider Enrollment, please copy, complete, and return the DEA Number form for each prescriber in your practice. Please send the information to the following address:

EDS Provider Enrollment Unit
P.O. Box 300009
Raleigh, North Carolina 27622

FAX: 919-851-4014
 

EDS, 1-800-688-6696 or 919-851-8888


Attention: Rural Health Clinics and Federally Qualified Health Centers

Billing for Laboratory Services

The Centers for Medicare and Medicaid Services (CMS) Program Memorandum A-00-30 clarified that diagnostic laboratory tests furnished by personnel in a Rural Health Clinic (RHC)/Federally Qualified Health Center (FQHC) are not covered services reimbursed under the core visit because laboratory tests are beyond the scope of RHC/FQHC services. While the law requires that these providers provide routine diagnostic services, according to CMS, laboratory tests are not within the scope of services covered and reimbursed under this provision. Therefore, effective January 1, 2002, laboratory services (including the six required lab tests for RHC certification) furnished by the clinic must be reimbursed based on the fee schedule allowable under the provider's "C" suffix provider number.

Billing Guidelines

  • Nominal reimbursement is available for collecting samples for lab testing in addition to the amounts paid under the laboratory fee schedule. Only one collection fee is allowed for each venipuncture for each recipient encounter, regardless of the number of specimens drawn. When a series of specimens is required to complete a single test (e.g., glucose tolerance test), the series is treated as a single encounter. Only the provider who has extracted the specimen from the recipient may bill the collection code. Bill G0001 on the CMS-1500 claim under the RHC/FQHC's "C" suffix provider number.
  • RHC/FQHC fee schedules listing the laboratory rates can be obtained by contacting the Division of Medical Assistance (DMA) using the Fee Schedule Request form. Completed forms can be submitted by fax to 919-715-0896.

    Adjusting the Cost Report

    The cost of the technical aspects of the test must be adjusted from the cost report. These costs include associated space, equipment, supplies, facility overhead, and personnel.
     

    EDS, 1-800-688-6696 or 919-851-8888


    Attention: Maternity Care Coordination, Maternity Support, and Child Service Coordination Services

    Termination of Coverage

    Effective with date of service September 30, 2002, the following state-created codes will be end-dated: Refresher Childbirth (Y2045), Enhanced Maternity Care Coordination (Y2352), and Enhanced Child Service Coordination (Y2353). The N.C. Medicaid program will no longer cover these services.
     

    EDS, 1-800-688-6696 or 919-851-8888


    Attention: Maternity Care Coordination, Maternity Support, Child Service Coordination, and Maternal Outreach Worker Services

    New Codes for Maternal and Child Services

    Effective with date of service October 1, 2002, Maternity Care Coordination, Maternity Support, Child Service Coordination, and Maternal Outreach Worker services must bill the following CPT or HCPCS codes. The new codes replace the state-created codes listed below, in compliance with the implementation of national codes mandated by the Health Insurance Portability and Accountability Act (HIPAA).
     
    Old Code
    Old Description
    New

    Code

    New Description
    W8201 
    Maternity Care Coordination Initial 
    T1017 
    Maternity care coordination 
    W8202 
    Maternity Care Coordination Subsequent 
    Y2044 
    Maternity Care Coordination Home Visit 
    W8203 
    Childbirth Education 
    S9442 
    Childbirth education 
    W8204 
    Maternal Care Skilled Nurse Home Visit 
    T1001 
    Maternal care skilled nurse home visit 
    Y2046 
    Postpartum Home Visit 
    99501 
    Home visit for postnatal assessment and follow-up care
    Y2047 
    Newborn Home Visit 
    99502 
    Home visit for newborn care and assessment 
    Y2049 
    Intensive Psychosocial Counseling 
    96152 
    Health and behavior intervention
    Y2155 
    Child Service Coordination 
    T1016 
    Child service coordination 
    Y2525 
    Maternal Outreach Worker Brief 
    S9445 
    Maternal outreach worker services 
    Y2526 
    Maternal Outreach Worker Standard 
    Y2527 
    Maternal Outreach Worker Extended 

    For a description of the policies relative to these new codes, please refer to August 2002 Special Bulletin IV, HIPAA Code Conversion. This information supersedes previously published policies and guidelines.
     

    EDS, 1-800-688-6696 or 919-851-8888


    Attention: Home Health Agencies, Private Duty Nursing Providers, and Community Alternatives Program Case Managers

    Conversion of Home Health Supply Codes to National Codes

    Congress has mandated that all payer sources comply with guidelines of the Health Insurance Portability and Accountability Act (HIPAA). This includes using standardized national codes for services that are common to all carriers. As codes are end-dated and new codes are added, providers will be notified in the general Medicaid bulletin.

    Some of the codes currently used will be replaced by multiple codes, and some will be deleted and replaced with existing codes. Read each description carefully to ensure that the correct size, quantity or preparation is billed. For example, the current code for gauze elastic bandages (Kling, Kerlix, roller gauze) is W4602 and is priced per roll; the replacement codes will be A6263, A6264, A6405, and A6406. The new codes are priced per linear yard.

    Current codes shown below will be end-dated effective with date of service September 30, 2002. The new codes will be effective with date of service October 1, 2002.
     

    Home Health Supplies
    Current
    Code
    New
    Code
    Description
    Maximum
    Rate/Unit
        Dressing Supplies  
    W4601 W4653 
    A6216 
    Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing 
    $ 4.07 
    W4601 W4653 
    A6217 
    Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing 
    .05 
    W4601 W4653 
    A6218 
    Gauze, non-impregnated, non-sterile, pad size more than 48 sq. in. without adhesive border, each dressing 
    .05 
    W4602 
    A6263 
    Gauze, elastic, non-sterile, all types, per linear yard 
    .29 
    W4602 
    A6264 
    Gauze, non-elastic, non-sterile, per linear yard 
    .48 
    W4602 
    A6405 
    Gauze, elastic, sterile, all types, per linear yard 
    .33 
    W4602 
    A6406 
    Gauze, non-elastic, sterile, all types, per linear yard 
    .79 
    W4668 
    K0573 
    Tape, waterproof, per 18 sq. in. 
    6.73 
        Intravenous Therapy and Parenteral Supplies  
    W4649 
    A4209 
    Syringe with needle, sterile 5 cc or greater, each 
    .31 
    W4650 
    A4213 
    Syringe, sterile, 20 cc or greater, each 
    1.08 
    W4654 
    A4259 
    Lancets, per box of 100 
    12.68 
        Miscellaneous Supplies  
    W4618 
    A4554 
    Disposable underpads, all sizes (e.g., Chux's) 
    $ 5.71 
        Skin Care (Decubitus) Supplies  
    W4620

    W4621 

    E0191 
    Heel or elbow protector, each
    8.45 
        Solutions  
    W4644 
    A4246 
    Betadine or pHisoHex solution, per pint 
    5.59 
        Tracheostomy Supplies  
    W4154 
    S8181 
    Tracheostomy tube holder 
    4.07 
    W4624 
    A4625* 
    Tracheostomy care kit for new tracheostomy 
    6.01 
    W4624 
    A4629* 
    Tracheostomy care kit for established tracheostomy 
    4.73 

    * Denotes existing codes. Please note that these are existing codes replacing W4624.

    Providers must bill their usual and customary charges.
     

    Dot Ling, Medical Policy Section
    DMA, 919-857-4021


    Attention: Durable Medical Equipment Providers

    Addition of HCPCS Code K0195

    Effective with date of service August 1, 2002, code K0195, elevating legrest, pair (for use with capped rental wheelchair base), has been added to the Capped Rental category of the Durable Medical Equipment Fee Schedule. The maximum reimbursement rates for code K0195 have been established as follows:
     
    Monthly rental rate 
    $ 20.97 
    New purchase rate 
    209.70 
    Used purchase rate 
    157.27 

    Prior approval is required. The lifetime expectancy of these legrests is three years. Providers must bill their usual and customary charges.
     

    Melody B. Yeargan, P.T., Medical Policy Section
    DMA, 919-857-4020


    Attention: Psychiatric Residential Treatment Facility Providers

    Billing Guidelines for Psychiatric Residential Treatment Facility Services

    Prior to April 1, 2002, claims submitted by a Psychiatric Residential Treatment Facility (PRTF) processed as Inpatient Nursing Homeclaims. Effective April 1, 2002, claims are now processed and are reflected on the Remittance and Status Report (RA) as Inpatient Hospital claims. Providers using North Carolina Electronic Claim Submission (NCECS) software will continue to use the UB-92 Nursing Home claims option to enter and submit the claim information. However, additional information is required on the claim.

    Required changes and additional fields are:

    1. Form Locator 4 - TYPE OF BILL

    2. The type of bill remains the same as 891.
       
    3. Form Locator 7 - COVERED DAYS

    4. Enter the number of covered days that correspond with the dates of service that are being billed. Claims must always be billed for more than one day of service and can span different months on the same claim. For example, if a recipient is admitted on April 30, the last day of the month, the "from" date of service is 04302002. The "through" date of service must be any date greater than 04302002.
       
    5. Form Locator 17 - ADMISSION DATE

    6. The admission date must always be entered on the claim <MMDDYYYY>.
       
    7. Form Locator 18 - ADMISSION HOUR

    8. A valid admission hour, 00 through 23, is required.

      00 = 12:00-12:59 Midnight 12 = 12:00-12:59 Noon
      01 = 01:00-01:59 13 = 01:00-01:59
      02 = 02:00-02:59 14 = 02:00-02:59
      03 = 03:00-03:59 15 = 03:00-03:59
      04 = 04:00-04:59 16 = 04:00-04:59
      05 = 05:00-05:59 17 = 05:00-05:59
      06 = 06:00-06:59 18 = 06:00-06:59
      07 = 07:00-07:59 19 = 07:00-07:59
      08 = 08:00-08:59 20 = 08:00-08:59
      09 = 09:00-09:59 21 = 09:00-09:59
      10 = 10:00-10:59 22 = 10:00-10:59
      11 = 11:00-11:59 23 = 11:00-11:59
       

    9. Form Locator 21 - DISCHARGE HOUR

    10. When the recipient has been discharged, a valid discharge hour, 00 through 23, is also required (see chart above).
       
    11. Form Locator 22 - PATIENT STATUS

    12. A valid patient status is now required.

      01 = Discharged to home or self care (routine discharge).
      02 = Discharged/transferred to another short-term general hospital.
      05 = Discharged/transferred to another type of institution for inpatient care or referred for outpatient services to another institution.
      07 = Left against medical advice.
      20 = Expired.
      30 = Still a patient or expected to return for outpatient services.
       

    13. Form Locator 39 - VALUE CODES

    14. Use value code 23 to indicate the Patient Monthly Liability (PML) amount. The PML amount is required on all claims beginning the first of the month following the thirtieth day from the date of admission. Failure to enter the code and PML amount (even if the amount is $0.00) will result in denial of the claim.
       
    15. Form Locator 76 - ADMITTING DIAGNOSIS CODE
    16. The admitting diagnosis code is now required in form locator 76, as well as in the principal diagnosis section of the claim. These diagnoses are also required to be further subdivided. For example, 296 (Affective Psychoses) is now required to be further subdivided to 296.2. Please refer to the ICD-9-CM code book for accurate codes.
    Refer to the sample claims listed below.
    Sample 1 shows the required fields for claims submitted within the first thirty (30) days when the PML is not required.
    Sample 2 shows the correct way to bill when the PML is required.
     

    EDS, 1-800-688-6696 or 919-851-8888


    Attention: Durable Medical Equipment Providers

    Completion of Certificate of Medical Necessity and Prior Approval Forms

    Current statistics show that almost 50 percent of all Certificate of Medical Necessity and Prior Approval (CMN/PA) forms sent to EDS for processing are returned to the provider as unresolved due to incomplete documentation. Of this percentage, nearly 30 percent are returned again for the same problem. Efforts to resolve problems with incomplete CMN/PA forms are delaying the review and disposition of durable medical equipment (DME) requests. EDS will not process incomplete forms. Incomplete forms returned to providers must be corrected and resubmitted to EDS within 60 days of the initial review or the request will be voided.

    Please ensure that each request corresponds to the instructions for completion of the CMN/PA form given in step 2 of subsection 6.4 of the N.C. Medicaid Durable Medical Equipment manual. It is not necessary to complete fields 3, 6, and 10. Entering ICD-9-CM codes in fields 11 and 12 and a CPT code in field 13 is optional. All of the remaining fields must be completed. Field 24 is required for the following HCPCS codes: E0202, E0607, E0608, E0609, E0480, E0650, E0651, E0652, E0784, E0935, W4006, and W4007.

    N/A must only be used in the following fields under the following circumstances:

    When completing field 25, be sure to refer to Appendix F of the N.C. Medicaid Durable Medical Equipment manual for requirements for selected items, including apnea monitors, bi-level therapy, CPAP, external insulin pumps, oxygen and oxygen equipment, portable pulse oximeters, pressure reducing support surfaces, TENS units, therapeutic ventilators, and wheelchairs.

    When completing field 26, be sure to fully identify the equipment that is being requested. The provider's return address must be entered in field 29. Failure to do so will delay the return of the form. A stamped address may be used. All of the information provided must be accurate and thorough.

    Note: Each page of documentation with the CMN/PA must contain the recipient's name and Medicaid identification (MID) number. Effective immediately, EDS will retain all documentation attached to the CMN/PA and the white (original) copy of the form. The yellow and pink copies will be returned to the provider. It is the provider's responsibility to maintain copies for their records.
     

    EDS, 1-800-688-6696 or 919-851-8888


    Attention: Dental Providers and Ambulatory Surgical Center Providers

    Billing When Dental Services are Rendered in an Ambulatory Surgical Center

    Dental Providers

    If a Medicaid recipient is physically unmanageable, medically compromised or severely mentally retarded and will not cooperate for treatment in the dental office, treatment can be completed in an Ambulatory Surgical Center (ASC). The ADA claim form is used by dentists for billing dental services. The dentist's billing instructions do not change, except for the place of service. Since the service is rendered in the ASC, the place of service code "F" must be entered in block 49 on the ADA claim form. Services that normally require prior approval are handled in the usual manner.

    Ambulatory Surgical Center Providers

    ASC bills for facility use. The ASC claims are filed on the CMS-1500 claim form. The facility rates for ambulatory dental services are priced based on total time, utilizing ASC Groups 1 through 4, as outlined below:
     

    ASC Group
    Total Time
    up to 30 minutes 
    31 - 60 minutes 
    61 - 90 minutes 
    over 90 minutes 

    For ASC dental treatment, specific changes in ASC billing procedures are listed below:

    EDS, 1-800-688-6696 or 919-851-8888


    Attention: Carolina ACCESS Providers

    Change in Carolina ACCESS Override Policy

    Effective September 1, 2002, Carolina ACCESS (CA) overrides will no longer be approved when an enrollee has failed to establish a medical record with the primary care provider (PCP) designated on the enrollee's Medicaid identification (MID) card. The CA contract requires PCPs to coordinate care for their enrollees. This means that PCPs must either schedule an appointment for enrollees based on the standards of appointment availability or authorize another provider to treat the enrollee. The contract defines the standards of appointment availability as: It is the responsibility of the treating provider to obtain authorization for treatment from the PCP listed on the recipient's MID card prior to treatment. If authorization is requested after services have been rendered, claims may deny. No override will be considered unless the PCP has been contacted and refused to authorize treatment.

    Override requests must be submitted using the Override Request form and sent to EDS within six months of the date of service. EDS has 30 days to evaluate the request.

    The Division of Medical Assistance (DMA) sends a monthly enrollment report to each PCP to assist in identification of their enrollees. DMA also sends a monthly referral report to each PCP so they can verify the validity and accuracy of the referrals. PCPs must document all referrals in the patient record. It is the responsibility of the PCP to review the reports and report discrepancies to their regional Managed Care Consultant for investigation.
     

    Managed Care Section
    DMA, 919-857-4022


    Attention: Hospital Providers

    Revision of Utilization Review Plans

    The Code of Federal Regulations (CFR) requires that hospitals (general, psychiatric, critical access, rehabilitation) providing inpatient services for Medicaid recipients must have a written Utilization Review (UR) plan approved by their state Medicaid program. The plan requirements are found at 42 CFR 456.50 through 456.145. This citation has been reprinted in its entirety as Appendix E of the N.C. Medicaid Hospital Services manual. Annual revision of UR plans is not necessary.

    Revision of a hospital UR plan is necessary only when one of the following occurs:

    1. The hospital name changes.
    2. The hospital has a change in ownership.
    3. The physical location of the facility changes.
    4. There is a change in the number or type of specialty beds.
    New or revised UR plans should be mailed to:

    Division of Medical Assistance
    Medical Policy Section
    Hospital Utilization Review
    2511 Mail Service Center
    Raleigh, NC 27699-2511
     

    Ann H. Kimbrell, R.N., Institutional Services
    DMA, 919-857-4020


    Attention: Physicians, Nurse Practitioners, Nurse Midwives, and Health Departments

    Varicella-Zoster Immune Globulin, Human, for Intramuscular Use (CPT 90396), Billing Guidelines

    The N.C. Medicaid program covers Varicella-zoster immune globulin, human, for intramuscular use (CPT 90396). For Medicaid billing, one unit represents 125 units of the Varicella-zoster immune globulin. Providers must indicate the number of Medicaid units given in block 24G on the CMS-1500 claim form. For example, 625 units given in 6.25 ml = 5 Medicaid units. Providers must bill their usual and customary charge.
     

    EDS, 1-800-688-6696 or 919-851-8888


    Attention: Independent Practitioner Providers, Developmental Evaluation Centers, Public Health Agencies, Area Mental Health Centers, Home Health Providers, Hospital Outpatient Clinics, and Physician Services

    Prior Approval of Outpatient Specialized Therapy Services

    Beginning October 1, 2002, Medical Review of North Carolina (MRNC) under a contract with the Division of Medical Assistance (DMA) will process the requests for prior approval of outpatient specialized therapy services provided to Medicaid recipients. Therapy services encompass all outpatient treatment for occupational (OT), physical (PT), speech (ST), respiratory (RT), and audiological therapy regardless of where the services are provided. MRNC will review these services and authorize care at designated trigger points. Services provided in an inpatient setting such as nursing homes, acute rehabilitation facilities, and hospitals are not included.

    After the trigger points have been reached, claims will not process without prior approval authorization.

    Note: HMO and Medicare recipients are exempt from this policy.

    Note: For Local Educational Agencies (LEAs), the prior approval process is deemed met by the IEP process.

    Workshops for Outpatient Specialized Therapy Prior Approval Process

    Detailed instructions about the prior approval process will be provided in workshops scheduled for September 2002. There is no charge for the workshops. However, to ensure adequate seating, please complete and submit the Outpatient Specialized Therapy Prior Approval Process Workshop registration form or register online beginning September 1, 2002, at http://www.mrnc.org under the News and Upcoming Events section. Workshops will begin at 10:00 a.m. and end at 1:00 p.m.

    Please access and print the PDF version of the September 2002 Special Bulletin V, Outpatient Specialized Therapies, from the DMA website and bring it with you.

    Directions to the sites.

    Registration form for the Outpatient Specialized Therapy Prior Approval Process Workshops.
     
     
    September 10, 2002
    Park Inn Gateway Conference Center
    909 US Highway 70 SW
    Hickory, NC 
    September 11, 2002
    Hilton Greenville
    207 Greenville Blvd SW
    Greenville, NC 
    September 12, 2002
    McKimmon Center
    Raleigh, NC 

    Directions to the Outpatient Specialized Therapy Prior Approval Process Workshops

    Park Inn Gateway Conference Center - Hickory, North Carolina
    Take I-40 to exit 123. Follow signs to Highway 321 North. Take the first exit (Hickory exit) and follow the ramp to the stoplight. Turn right at the light onto Highway 70. The Gateway Conference Center is on the right.

    Hilton - Greenville, North Carolina
    Take Highway 264 East to Greenville. Turn right onto Allen Road in Greenville. Travel approximately 2 miles. Allen Road becomes Greenville Boulevard/Alternate 264. Follow Greenville Boulevard for 2½ miles to the Hilton Greenville, which is located on the right.

    McKimmon Center - Raleigh, North Carolina
    Traveling East on I-40
    Take exit 295 and turn left onto Gorman Street. Travel approximately one mile. The McKimmon Center is located on the right between Avent Ferry Road and Western Boulevard.

    Traveling West on I-40
    Take exit 295 and turn right onto Gorman Street. Travel approximately one mile. The McKimmon Center is located on the right between Avent Ferry Road and Western Boulevard.

    Carol Robertson
    Nora Poisella
    Behavioral Health Services
    DMA, 919-857-4020
     


    Attention: All Providers

    Medicare Part B Seminar Schedule

    Seminars for billing Medicare Part B services are scheduled for September 2002. Because the process for billing these services will change for claims submitted with dates of service October 1, 2002 and after, these seminars will be used to instruct providers on "how to bill" Medicaid for Medicare Part B services provided to Medicare/Medicaid recipients after the change is implemented.

    The process for billing these services will be published in the September 2002 Special Bulletin VI, Medicare Part B, for use in the Medicare Part B seminar. However, the Division of Medical Assistance (DMA) is unable to print copies of special and general Medicaid bulletins for distribution to providers due to the State's severe budget problems. The Medicare Part B Special Bulletin will not be distributed to providers attending the seminars. Providers must access and print the PDF version of the September 2002 Special Bulletin VI, Medicare Part B and bring it to the seminar.

    Due to limited seating, preregistration is required and limited to two staff members per office. Unregistered providers are welcome to attend when reserved space is adequate to accommodate. Providers may register for the Medicare Part B seminar by completing and submitting the Medicare Part B Seminar registration form or providers can register online. Please select the most convenient site and return the completed registration form to EDS as soon as possible. Seminars begin at 10:00 a.m. and end at 1:00 p.m. Providers are encouraged to arrive by 9:45 a.m. to complete registration.

    Directions to the sites.

    Wednesday, September 4, 2002
    Holiday Inn Conference Center
    530 Jake Alexander Blvd., S.
    Salisbury, NC
    Thursday, September 5, 2002
    Ramada Inn Plaza
    3050 University Parkway
    Winston-Salem, NC 
    Tuesday, September 10, 2002
    WakeMed
    Andrews Conference Center
    3000 New Bern Avenue 
    Raleigh, NC
    Thursday, September 12, 2002
    Blue Ridge Community College
    Bo Thomas Auditorium
    College Drive
    Flat Rock, NC 
    Tuesday, September 17, 2002
    Coast Line Convention Center 
    501 Nutt Street 
    Wilmington, NC 
    Wednesday, September 18, 2002
    Hilton Greenville
    207 Greenville Blvd SW
    Greenville, NC 

    Directions to the Medicare Part B Seminars

    Holiday Inn Conference Center - Salisbury, North Carolina
    Traveling South on I-85
    Take exit 75. Turn right onto Jake Alexander Boulevard. Travel approximately ½ mile. The Holiday Inn is located on the right.

    Traveling North on I-85
    Take exit 75. Turn left onto Jake Alexander Boulevard. Travel approximately ½ mile. The Holiday Inn is located on the right.

    Ramada Inn Plaza - Winston-Salem, North Carolina
    Take I-40 Business to the Cherry Street exit. Continue on Cherry Street for approximately 2 to 3 miles. Turn left at the IHOP Restaurant. The Ramada Inn Plaza is located on the right.

    WakeMed Andrews Conference Center - Raleigh, North Carolina
    Driving and Parking Directions
    Take the I-440 Raleigh Beltline to exit 13A, New Bern Avenue.

    Paid parking ($3.00 maximum per day) is available on the top two levels of parking deck P3. To reach the parking deck, turn left at the fourth stoplight on New Bern Avenue, and then turn left at the first stop sign. Parking for oversized vehicles is available in the overflow lot for parking deck P3. Handicapped accessible parking is available in parking lot P4, directly in front of the conference center.

    To enter the Andrews Conference Center, follow the sidewalk toward New Bern Avenue past the Medical Office Building to entrance E2 of the William F. Andrews Center for Medical Education.

    Illegally parked vehicles will be towed. Parking is not permitted at East Square Medical Plaza, Wake County Human Services or in parking lot P4 (except for handicapped accessible parking).

    Blue Ridge Community College - Flat Rock, North Carolina
    Take I-40 to Asheville. Travel east on I-26 to exit 22. Turn right and then take the next right. Follow the signs to Blue Ridge Community College. Turn left at the large Blue Ridge Community College sign. The college is located on the right. Pass the college's main entrance and turn right into the college entrance past the pond. The parking lot is on the left.

    Coast Line Convention Center - Wilmington, North Carolina
    Take I-40 east to Wilmington. Take the Highway 17 exit. Turn left onto Market Street. Travel approximately 4 or 5 miles to Water Street. Turn right onto Water Street. The Coast Line Inn is located one block from the Hilton on Nutt Street behind the Railroad Museum.

    Greenville Hilton - Greenville, North Carolina
    Take Highway 264 east to Greenville. Turn right onto Allen Road in Greenville. Travel approximately 2 miles. Allen Road becomes Greenville Boulevard/Alternate 264. Follow Greenville Boulevard for 2½ miles to the Hilton Greenville, which is located on the right.

    EDS, 1-800-688-6696 or 919-851-8888



     
     

    Checkwrite Schedule


    August 13, 2002  September 4, 2002  October 15, 2002 
    August 20, 2002  September 10, 2002  October 22, 2002 
    August 29, 2002  September 17, 2002  October 30, 2002 
    September 26, 2002 

    Electronic Cut-Off Schedule


    August 9, 2002  August 30, 2002  October 25, 2002 
    August 16, 2002  September 6, 2002  October 18, 2002 
    August 23, 2002  September 13, 2002  October 11, 2002 
      September 20, 2002   

    Electronic claims must be transmitted and completed by 5:00 p.m. on the cut-off date to be included in the next checkwrite. Any claims transmitted after 5:00 p.m. will be processed on the second checkwrite following the transmission date.



     
     
     
    _____________________ _____________________
    Nina M. Yeager, Director Ricky Pope
    Division of Medical Assitance Executive Director
    Department of Health and Human Services EDS

     
     
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