2003 Medicaid Bulletin Index
Medicaid bulletin articles and special bulletins organized by provider type for 2003.
All Providers:
- A Reminder about Preadmission Screening
and Annual Resident Reviews, 12/03
- Abortion Procedures - Revision to Billing
Guidelines, 10/03
- Ambulatory Visit Limits and Diagnosis Code
V900, 6/03
- Anesthesia -Billing CPT Anesthesia
Codes Instead of Surgical Codes, 1/03
- Anesthesia - Conversion from CPT
Surgical Coding to CPT Anesthesia Coding, 5/03
- Anesthesia Billing for Labor and Delivery,
11/03
- Anesthesia Services Conversion to
CPT Anesthesia Codes, 9/03
- Corrected 1099 Requests:
- Business Associate Agreements, 5/03
- Carolina ACCESS Response to Hurricane
Isabel, 10/03
- Condition Codes D7 and D9 Change for Medicare
Overrides, Part A and Part B, 9/03
- CPT Anesthesia Codes, 11/03
- CPT Code Update 2003:
- CPT Code Update for 2002, 5/03
- CPT Code Update: Time Limit Override
for New 2002 Codes, 8/03
- CPT Codes Covered for Dates of Service on
or After January 1, 2002, 7/03
- CPT Update for 2003, 1/03
- Depo-Provera (Medroxyprogesterone Acetate,
HCPCS Code J1051, 50 mg Injection) - Billing Guidelines, 10/03
- Dexamethasone Acetate (HCPCS Code J1094,
1 mg Injection) - Billing Guidelines, 10/03
- Electronic Funds Transfer Form, 5/03
- Electronic Submissions of FL2s, 8/03
- Endoscopy CPT Base Codes and Their Related Procedures:
- General Medicaid Billing Seminars:
- HIPAA Implementation Training Seminars:
- HIPAA Implementation Update, 10/03
- HIPAA Transaction Implementation:
- HIPAA Transaction Testing, 10/03
- HIPAA - Questions and Answers, 5/03
- HIPAA Update, Special Bulletin II, June 2003
- HIPAA Update: Change to Implementation Date:
- Influenza Vaccine Reimbursement Guidelines,
10/03
- Insulin Injection (Per 5 Units, HCPCS
Code J1815) Billing Guidelines, 10/03
- Managed Care Seminars:
- Mecklenburg County Managed Care
Update, 2/03
- Medicaid Contact Information, 12/03
- Medicaid Coverage for Pregnancy-Related
Services, 7/03
- Medicaid Credit Balance Reporting, 11/03
- Medical Coverage Policies:
- Medicare - Medicaid Matching Project, 9/03
- New Address for Medical Review of N.C.,
6/03
- New Billing Guidelines for Abortion Procedures,
9/03
- New Billing Guidelines for Sterilization
Procedures, 0/03
- New Mailing Address for the Division
of Medical Assistance, 10/03
- Performance Bonds, 1/03
- Progesterone, per 50 mg (HCPCS
Code J2675) - Coverage Reinstated, 0/03
- Proposed Medical Coverage Policies:
- Provider Information Update:
- Remittance and Status Report Changes:
- Revised Health Insurance Information
Referral Form, 2/03
- Routine Newborn Circumcision Coverage
Policy Clarification, 3/03
- Severe Acute Respiratory Syndrome Assessment,
5/03
- Sodium Hyaluronate for Intra-Articular
Injection – Billing Guidelines, 3/03
- State-Created Diagnosis Codes, 9/03
- Sterilization Procedures - Revision
to Billing Guidelines, 10/03
- Supplemental Security Income Medicaid Recipients
with Incorrect Medicare Indicators, 11/03
- Tax Identification Information, 12/03
- Third Party Health Insurance and
Medicaid Eligibility Policy Clarification, 2/03
- Transplants: Submitting Claims
for Reimbursement, 6/03
- Unidentifiable Provider Numbers,
3/03
- Unlisted Procedure Code Claims and EOB 1224
Revision, 8/03
- Update on HIPAA Implementation Training
Seminars, 3/03
- Update to Regional Managed Care Consultant
List, 2/03
- Zoledronic Acid, 1 mg (Zometa, J3487)
– Billing Guidelines Update, 1/03
Adult Care Home Providers:
Ambulance Service Providers:
- New Ambulance Billing Guidelines:
Ambulatory Surgical Centers:
Anesthesiologists:
Area Mental Health Centers:
- Addition of V Code Diagnosis for Outpatient
Specialized Therapies, 5/03
- Area Mental Health and Residential Child Care Treatment Seminar Schedule:
- Billing Changes for CAP-MR/DD Services,
7/03
- Billing Update and Population Groups
for CAP-MR/DD Services, 9/03
- Cancellation of Area Mental Health and
Residentail Child Care Treatment Seminars, 9/03
- Clarification of Billing Instructions
for Outpatient Specialized Therapies, 6/03
- Clarification on the Use of the F2 Stamp,
9/03
- Correction to Billing Unit for HCPCS Code
H0040, 12/03
- Correction to V Code Diagnosis for Outpatient Occupational
Therapy Services, 7/03
- Criterion #5 Services - Authorization
Process, 12/03
- Directions to the Area Mental Health and Residential Child Care Treatment
Seminars:
- HIPAA Code Conversions, Special Bulletin IV,
November 2003
- N.C. Medicaid Criteria for Continued
Acute Stay in an Inpatient Psychiatric Facility, 3/03
- Out-of-State Youth Residential Placements,
12/03
- Outpatient Specialized Therapies and Independent
Practitioners Medical Coverage Policy Revisions, 4/03
- Outpatient Specialized Therapies Prior Approval Process:
- Respiratory Therapy Criteria, 7/03
- Seminars for HIPAA Code Conversions
for Services Provided to Children under the Age of 21, 7/03
At-Risk Case Management:
Carolina ACCESS Providers:
- Carolina ACCESS Medical Records Guidelines,
6/03
- Carolina ACCESS Enrollment, Referral,
Emergency Room, and Utilization Reports, 7/03
- Carolina ACCESS Web-Based Reports, 12/03
- Change in Carolina ACCESS Editing for
Anesthesiology, Pathology or Radiology Services, 7/03
- New Primary Care Provider Application Packet,
10/03
- Quarterly Utilization Review Report, 3/03
- Reduction in Management Fee, 3/03
- Referral Policy for Specialty Care, 7/03
Certified Registered Nurse Anesthetists:
Children's Developmental Service Agencies:
Community Alternatives Program Case Managers:
Community Alternatives Program Services for Children:
Community Alternatives Program Services for Disabled Adults:
Community Alternatives Program Services for Persons with AIDS:
Community Alternatives Program Services for Persons with Mental Retardation/Developmental
Disabilities:
Developmental Evaluation Centers:
Dental Providers:
Dialysis Providers:
- Calcitriol Injection, 0.1 mcg (J0636)
- Billing Guidelines, 9/03
- Darbepoetin Alfa, 5 mcg (Aranesp,
J0880) – Billing Guidelines, 3/03
- Doxercalciferol, 1 mcg (Hectoral, J1270)
- Billing Guidelines , 8/03
- Ferrlecit (Sodium Ferric Gluconate
Complex in Sucrose, HCPCS Code J2916, 12.5 mg Injection) - Billing Guidelines,
10/03
- Occurrence Code Change for First Date
of Ongoing Dialysis Treatment, 3/03
- Venofer (Iron Sucrose Injection, HCPCS
Codes J1755 and J1756) - Billing Guidelines, 10/03
- Zemplar (Paracalcitrol, HCPCS Code J2501,
1 mcg Injection) - Billing Guidelines, 10/03
Durable Medical Equipment Providers:
- Amended Implementation of Transfer of Assets
Policy for Specified Home Care Services, 2/03
- Change in Code for Durable Medical
Equipment Repairs, 12/03
- Conversions to National Miscellaneous
Codes, 12/03
- Deletion of Codes E0452 and E0453 and Addition
of Codes K0532 and K0533, 6/03
- Deletion of Codes W4007 and W4035,
9/03
- Durable Medical Equipment Prescriptions
and Certificate of Medical Necessity and Prior Approval Forms, 3/03
- End-Dated Codes, 10/03
- End-Dated Codes W9934 and W4046, 11/03
- Fee Schedules Available on the Internet,
2/03
- HCPCS Code Changes:
- HCPCS Code Changes for Durable Medical
Equipment, 11/03
- Implementation of Transfer of Assets Policy
for Specified Home Care Services, 1/03
- Length of Need Documentation, 7/03
- Reimbursement Rate Correction for HCPCS
Code S8490, 10/03
- Removal of Codes E1405 and E1406, 7/03
- Use of Modifiers for Durable Medical Equipment
Claims, 7/03
Electronic Billers:
- NCECS Software Seminar:
- North Carolina Electronic Claims Submission Web-Based Tool:
Federally Qualified Health Centers:
Head Start Programs:
Health Check Providers:
Health Department Dental Clinics:
- ADA Code Updates for the Year 2003 and the New Dental Claim Form:
Health Departments:
- Addition of V Code Diagnosis for Outpatient Specialized Therapies, 5/03
- Agalsidase Beta, 35 mg (Fabrazyme,
J3490) - Billing Guidelines, 8/03
- Alefacept, 7.5 mg IV; 15 mg IM (Amevive,
J3490) - Billing Guidelines , 8/03
- Billing Health Assessments for Refugees,
10/03
- Bortezomib, 3.5 mg (Velcade, J9999) - Billing
Guidelines, 8/03
- Clarification of Billing Instructions
for Outpatient Specialized Therapies, 6/03
- Code Crosswalk Clarification, 8/03
- Correction to V Code Diagnosis for Outpatient Occupational
Therapy Services, 7/03
- Factor VIIa (Coagulation Factor, Recombinant)
per 1.2 mg (Novoseven, Q0187) – Billing Guidelines, 2/03
- Family Planning Claims Denials, 9/03
- Fulvestrant, 250mg/5ml (Faslodex, J9999)
– Billing Guidelines, 2/03
- Home Visit for Postnatal Assessment
and Follow-Up Care When There is No Delivery Code, 9/03
- Immune Globulin Intravenous Injection (J1563,
1 gm and J1564, 10mg) - Billing Guidelines, 9/03
- Injectable Drug Coverage through the
Pharmacy and Physician’s Drug Programs, 4/03
- Leuprolide Acetate Implant, 65mg (Viadur,
J9219) – Billing Guidelines, 2/03
- Medroxyprogesterone Acetate/Estradiol
Cypionate, 5 mg/25 mg (Lunelle, HCPCS Code J1056) – Billing Guidelines, 4/03
- Outpatient Specialized Therapies and Independent
Practitioners Medical Coverage Policy Revisions, 4/03
- Outpatient Specialized Therapies Prior Approval Process:
- Pegfilgrastim, 6mg (Neulasta, S0135) – Billing
Guidelines, 2/03
- Progestacert IUD, W5142 Now End-dated, 4/03
- Purchasing Drugs for Administration in
a Provider's Office, 9/03
- Respiratory Therapy Criteria, 7/03
- Teleconference for Local Health Departments
on Revisions to the Health Check Billing Requirements, 4/03
- Zemplar (Paracalcitrol, HCPCS Code J2501,
1 mcg Injection) - Billing Guidelines, 10/03
Hearing Aid Providers:
HIV Case Management Services Providers:
Home Health Agencies:
- Amended Implementation of Transfer of Assets
Policy for Specified Home Care Services, 2/03
- Clarification of Billing Instructions
for Outpatient Specialized Therapies, 6/03
- Deletion of Skilled Nursing HCPCS Codes
W9952 through W9959, 7/03
- Denials Due to Incorrect Billing Procedure,
7/03
- Fee Schedules Available on the Internet,
2/03
- HCPCS Code Changes for Home Health Supplies:
- Implementation of Transfer of Assets Policy
for Specified Home Care Services, 1/03
- Outpatient Specialized Therapies and Independent
Practitioners Medical Coverage Policy Revisions, 4/03
- Outpatient Specialized Therapies Prior Approval
Process:
- Rate Increase for Ostomy Supplies, 11/03
- Respiratory Therapy Criteria, 7/03
- Use of Revenue Codes for Home Health
Skilled Nursing Claims, 9/03
Home Infusion Therapy Providers:
Hospice Providers:
Hospital Outpatient Clinics:
Hospitals:
- Billing for Certified Registered Nurse
Anesthetist Services, 2/03
- Clarification on Preadmission Review for
Psychiatric/Substance Abuse Treatment, 8/03
- Change to Medicare Part B:
- Cochlear Implant Device – Billing Clarification,
1/03
- Criterion #5 Services - Authorization
Process, 12/03
- Delivery Services and Sterilization Procedures
for Undocumented Aliens, 12/03
- Denials Due to Incorrect Billing Procedure,
7/03
- Modifier YS for Teleconsults, 1/03
- N.C. Medicaid Criteria for Continued
Acute Stay in an Inpatient Psychiatric Facility, 3/03
- New Patient Status Codes, 05/03
- Prior Approval for Non-Emergency
Out-of-State Services, 6/03
- Update to Change to Medicare Part B Pricing
Policy, 12/03
Independent Practitioners:
Laboratory Services:
Local Education Agencies:
Mecklenburg County Providers:
Nurse Midwives:
- Calcitriol Injection, 0.1 mcg (J0636)
- Billing Guidelines, 9/03
- CPT Code 59025, 8/03
- Injectable Drug Coverage through the Pharmacy
and Physician’s Drug Programs, 4/03
- Medroxyprogesterone Acetate/Estradiol
Cypionate, 5 mg/25 mg (Lunelle, HCPCS Code J1056) – Billing Guidelines, 4/03
- Progestacert IUD, W5142 Now End-dated,
4/03
- Purchasing Drugs for Administration in
a Provider's Office, 9/03
Nurse Practitioners:
- Agalsidase Beta, 35 mg (Fabrazyme,
J3490) - Billing Guidelines, 8/03
- Alefacept, 7.5 mg IV; 15 mg IM (Amevive,
J3490) - Billing Guidelines, 8/03
- Amphotericin B - Change in Billing Guidelines,
9/03
- Billing Health Assessments for Refugees,
10/03
- Bortezomib, 3.5 mg (Velcade, J9999) - Billing
Guidelines, 8/03
- Calcitriol Injection, 0.1 mcg (J0636)
- Billing Guidelines, 9/03
- Darbepoetin Alfa, 5 mcg (Aranesp,
J0880) – Billing Guidelines, 3/03
- Durable Medical Equipment Prescriptions
and Certificate of Medical Necessity and Prior Approval Forms, 3/03
- Factor VIIa (Coagulation Factor, Recombinant)
per 1.2 mg (Novoseven, Q0187) – Billing Guidelines, 2/03
- Ferrlecit (Sodium Ferric Gluconate
Complex in Sucrose, HCPCS Code J2916, 12.5 mg Injection) - Billing Guidelines,
10/03
- Fulvestrant, 250mg/5ml (Faslodex, J9999)
– Billing Guidelines, 2/03
- Immune Globulin Intravenous Injection (J1563,
1 gm and J1564, 10 mg) - Billing Guidelines, 9/03
- Injectable Drug Coverage through the
Pharmacy and Physician’s Drug Programs, 4/03
- Laronidase, 2.9 mg/5 ml (Aldurazyme, J3490)
- Billing Guidelines, 8/03
- Leuprolide Acetate Implant, 65mg (Viadur,
J9219) – Billing Guidelines, 2/03
- Medroxyprogesterone Acetate/Estradiol
Cypionate, 5 mg/25 mg (Lunelle, HCPCS Code J1056) – Billing Guidelines, 4/03
- Octreotide Acetate, 1 mg (Sandostatin
LAR Depot, J2352) – Clarification to Billing Guidelines, 4/03
- Oxaliplatin, 50 mg (Eloxatin, J9999) - Billing
Guidelines, 9/03
- Pegfilgrastim, 6mg (Neulasta, S0135) – Billing
Guidelines, 2/03
- Progestacert IUD, W5142 Now End-dated,
4/03
- Purchasing Drugs for Administration in
a Provider's Office, 9/03
- Venofer (Iron Sucrose Injection, HCPCS
Codes J1755 and J1756) - Billing Guidelines, 10/03
- Zemplar (Paracalcitrol, HCPCS Code J2501,
1 mcg Injection) - Billing Guidelines, 10/03
Nursing Facility Providers:
OB/GYN Providers
Optical Providers:
Outpatient Behavioral Health Providers:
Pathologists:
Personal Care Services Providers:
Pharmacists:
Physician Assistants:
Physicians:
- Addition of V Code Diagnosis for Outpatient
Specialized Therapies, 5/03
- Agalsidase Beta, 35 mg (Fabrazyme,
J3490) - Billing Guidelines, 8/03
- Alefacept, 7.5 mg IV; 15 mg IM (Amevive,
J3490) - Billing Guidelines, 8/03
- Amphotericin B - Change in Billing Guidelines,
9/03
- Billing Health Assessments for Refugees,
10/03
- Bortezomib, 3.5 mg (Velcade, J9999) - Billing
Guidelines, 8/03
- Calcitriol Injection, 0.1 mcg (J0636)
- Billing Guidelines, 9/03
- Clarification of Billing Instructions
for Outpatient Specialized Therapies, 6/03
- Correction to V Code Diagnosis for Outpatient Occupational
Therapy Services, 7/03
- Darbepoetin Alfa, 5 mcg (Aranesp,
J0880) – Billing Guidelines, 3/03
- Durable Medical Equipment Prescriptions
and Certificate of Medical Necessity and Prior Approval Forms , 3/03
- Factor VIIa (Coagulation Factor, Recombinant)
per 1.2 mg (Novoseven, Q0187) – Billing Guidelines, 2/03
- Ferrlecit (Sodium Ferric Gluconate
Complex in Sucrose, HCPCS Code J2916, 12.5 mg Injection) - Billing Guidelines,
10/03
- Fulvestrant, 250mg/5ml (Faslodex, J9999)
– Billing Guidelines, 2/03
- Immune Globulin Intravenous Injection (J1563,
1 gm and J1564, 10 mg) - Billing Guidelines, 9/03
- Injectable Drug Coverage through the Pharmacyand
Physician’s Drug Programs, 4/03
- Laronidase, 2.9 mg/5 ml (Aldurazyme, J3490)
- Billing Guidelines, 8/03
- Leuprolide Acetate Implant, 65mg (Viadur,
J9219) – Billing Guidelines, 2/03
- Medroxyprogesterone Acetate/Estradiol
Cypionate, 5 mg/25 mg (Lunelle, HCPCS Code J1056) – Billing Guidelines, 4/03
- Modifier YS for Teleconsults, 1/03
- Octreotide Acetate, 1 mg (Sandostatin
LAR Depot, J2352) – Clarification to Billing Guidelines, 4/03
- Outpatient Specialized Therapies, 10/03
- Outpatient Specialized Therapies and Independent
Practitioners Medical Coverage Policy Revisions, 4/03
- Outpatient Specialized Therapies Prior Approval Process:
- Oxaliplatin, 50 mg (Eloxatin, J9999) - Billing
Guidelines, 9/03
- Pegfilgrastim, 6mg (Neulasta, S0135) – Billing
Guidelines, 2/03
- Prior Approval for Non-Emergency
Out-of-State Services, 6/03
- Progestacert IUD, W5142 Now End-dated,
4/03
- Purchasing Drugs for Administration in
a Provider's Office, 9/03
- Respiratory Therapy Criteria, 7/03
- Venofer (Iron Sucrose Injection, HCPCS
Codes J1755 and J1756) - Billing Guidelines, 10/03
- Zemplar (Paracalcitrol, HCPCS Code J2501,
1 mcg Injection) - Billing Guidelines, 10/03
Private Duty Nursing Providers:
Prescribers:
Radiologists:
Residential Treatment Providers:
Rural Health Clinics: