2009 Medicaid Bulletin Index
Medicaid bulletin articles and special bulletins organized by provider type for 2009.
NPI:
- Are You Ready for National Provider Identifiers?, 4/09
- Common National Provider Identifier Errors on Claims, 2/09
- EOB Codes for National Provider Identifiers, 3/09
- National Provider Identifier Claim Submission Instructions, 3/09
- National Provider Identifier Guidelines for CCNC/CA Providers, 5/09
- National Provider Identifier Guidelines for Claims Filed With a CCNC/CA Referral, 7/09
- National Provider Identifier Implementation, 5/09
- National Provider Identifier Implementation Announcement:
- National Provider Identifier Seminars:
- Recommended Taxonomy Codes for National Provider Identifier Mapping, 4/09
- Submitting ZIP+4 on Claims, 7/09
- Use of Medicaid Provider Number After National Provider Identifier Implementation, 4/09
All Providers:
- 2009 CPT Update, 2/09
- 2009/2010 Procedures for Prescribing Synagis for RSV Season, 10/09
- 2010 Checkwrite Schedule, 10/09
- Are You Ready for National Provider Identifiers?, 4/09
- Basic Medicaid Seminars:
- Billing CPT Procedure Code 72295 with Modifiers 76 or 77, 7/09
- Billing CPT Procedure Codes 93541, 93542, and 93543 with Modifier 51, 7/09
- Billing with CPT Procedure Codes 72291 and 72292, 2/09
- Billing with the North Carolina Electronic Claims Submission Web Tool, 8/09
- Bone Mass Measurement, 3/09
- Change in Deadline for Resubmision of Denied Claims for Annual Exam Visits for Family Planning Waiver Recipients, 3/09
- Change in Procedure Codes Covered Under the Family Planning Waiver, 6/09
- Changes to the Electronic Remittance Advice (835 Transaction), 3/09
- Changes to Prior Authorization Criteria for Growth Hormones, 6/09
- Changes to Prior Authorization Criteria for Sedative Hypnotics, 6/09
- Clarification for Completing the W-9, 7/09
- Clinical Coverage Policies:
- Corrected 1099 Requests for Tax Years 2006, 2007, and
2008 – Action Required by
March
1, 2009:
- Corrected Diagnosis Code for DTaP-IPV (Kinrix, CPT
Procedure Code 90696), 1/09
- Corrected Diagnosis Code for DTaP-Hib-IPV (Pentacel,
CPT Procedure Code 90698), 1/09
- Corrected Diagnosis List for CPT Codes 93228 and 93229, 4/09
- County of Residence for Adults in a Private-Living Situation with Medicaid for the Aged, Blind or Disabled, 8/09
- CPT Code Update 2009, 1/09
- CPT Procedure Code 89049, 8/09
- CPT Procedure Code 99170 Diagnosis List, 2/09
- CPT Procedure Codes 72295 and 62290, 2/09
- CPT Procedure Codes 93320, 93321, and 93325, 6/09
- CSC to Assume N.C. Medicaid Provider Enrollment, Credentialing, and Verification Activities,
- CSC to Initiate 12-Month Provider Verification and Credentialing Activities:
- Denials for CPT Procedure Code 96372 with an FP Modifier, 5/09
- Denials for CPT Procedure Codes 76376 and 76377, 2/09
- Denials for Endovascular Graft Repair of Thoracic Aortic Aneurysm, 4/09
- Denials of CPT Procedure Code 29873 with Modifier 51, 6/09
- Denials of CPT Procedure Code 96360, 96365, 96374, and 96375, 6/09
- DHHS Awards Contract for Replacement MMIS, 2/09
- Dietary Evaluation and Counseling, 11/09
- DMA Budget Initiative Web Page:
- DMA Website Redesign, 1/09
- EDS Announces New Name:
- Electronic Claim Submission EOB Code:
- Electronic Claims Submission, 7/09
- Electronic Claims Submission Exceptions:
- Electronic Claims Submission and Fund Transfers, 6/09
- Electronic Funds Transfer Requirement, 9/09
- Electronic Funds Transfers:
- Electronic Medicare Overrides, 8/09
- Electronic Recipient Eligibility Verification Tool, 9/09
- EOB Code Revisions, 10/09
- EOB Codes for National Provider Identifiers, 3/09
- False Claims Act Education Compliance for Federal Fiscal Year 2008, 7/09
- Flu Testing: CPT Codes 87400 and 87804, 12/09
- Genotyping and Phenotyping for HIV Drug Resistance Testing, 6/09
- HCPCS Procedure Code Changes for the Physician's Drug Program, 3/09
- Helpful Hints When Billing National Drug Codes, 9/09
- HIV Tropism Assay, 5/09
- Immune Globulin (Octagam), Intravenous, HCPCS Procedure Code J1568: Renewed Coverage, 9/09
- Implementation of Utilization Management by Local Mangement Entities, 6/09
- Influenza A (H1N1) 2009 Monovalent Vaccine and Reimbursement Guidelines for 2009/2010, 11/09
- Laboratory Billing Reminder, 3/09
- Legislative Mandate for Uniform Screening Program Tool for PASARR Screenings, 9/09
- Leuprolide Acetate Injectable (HCPCS Procedures Codes): Change in Billing Guidelines, 10/09
- List of Exceptions for Electronic Claim Submission, 10/09
- Local Management Entity Utilization Management Project, 3/09
- Mailing Correspondence and Inquiries, 8/09
- Medicaid Credit Balance Reporting:
- Medicaid Fraud and Abuse - Confidential Online Complaint Form, 4/09
- Medicaid Recipient/Applicant Due Process Appeals for Medical, Dental, and Behavioral Health Services, 4/09
- Medicaid Recipient Appeal Process/Early and Periodic Screening, Diagnosis, and Treatment, 12/09
- Medicaid Recipient Appeals, 10/09
- Medical Care Decisions and Advance Directives, 8/09
- Medical Genetic Counseling, 5/09
- Medically Necessary Oral Nutrition Products for Recipients Under the Age of 21, 2/09
- National Drug Code Information, 3/09
- National Provider Identifier Implementation, 5/09
- National Provider Identifier Implementation Announcement:
- National Provider Identifier Seminars:
- New Contact Information for Rate Setting Staff, 4/09
- North Carolina Electronic Claims Submission/Recipient Eligibility Verification Web Tool:
- North Carolina Electronic Claims Submisson/Recipient Eligibility Verification Web Tool, Special Bulletin III, September 2009
- Notice of Legislative Mandate for PASARR, 10/09
- Notice of Legislative Mandate for PASRR, 12/09
- Notice of Medicaid Identification Card Changes:
- Notice of Possible Legislative Mandate for Uniform Screening Program Tool for PASARR Screenings, 8/09
- Notice of Possible Medicaid Identification Card Changes, 7/09
- Obtaining Informed Consent on Sterilization Consent Forms, 11/09
- Paper Claim Submissions:
- Part D Drug Coverage Information, 5/09
- Payment Error Rate Measurement in North Carolina, 12/09
- Piedmont Cardinal Health Plan, 12/09
- Prior Authorization for Non-emergency Outpatient High-tech Radiology and Ultrasound Procedures:
- Provider Enrollment and Re-credentialing Fee, 9/09
- Provider Enrollment Packet Updates, 2/09
- Provider Exclusions, Fraud, and Abuse, 4/09
- Provider Information Regarding Changes in N.C. Health Choice Dental Benefits, 7/09
- Public Notice, 7/09
- Recipient Eligibility Benefit Inquiry and Response, 8/09
- Registration for Basic Medicaid Seminars, 3/09
- Registration for Health Check/EPSDT Seminars, 4/09
- Registration for the PASARR Segment of the Medicaid
Uniform Screening Tool, 1/09
- Reimbursement Rate for Targeted Case Management, 3/09
- Reimbursement Rate Update, 10/09
- Retroactive Eligibility for Family Planning Waiver, 11/09
- Rotavirus Vaccine, Human, Attenuated, 2-dose Schedule,
Live, for Oral Use (Rotarix, CPT Procedure 90681) Billing Guidelines, 1/09
- Seasonal Influenza Vaccine and Reimbursement Guidelines for 2009/2010, 10/09
- Services that Cannot be Reimbursed by the N.C. Medicaid Program, 8/09
- Status Update for the PASARR Segment of the Medicaid Uniform Screening Tool, 3/09
- Submitting Secondary and Tertiary Claims Electronically/837 Transaction, 12/09
- Submitting ZIP+4 on Claims, 7/09
- Suspension of New Enrollment for At-Risk Case Management Providers, 11/09
- The Controlled Substances Reporting System: The State's Newest Tool to Make Prescribing Opioids and Other Controlled Substances Safer and Easier, 7/09
- Time Limit Overrides, 7/09
- Top 10 EOBs:
- Top 10 List of Helpful Hints When Billing National Drug Codes, 4/09
- Top 10 Reasons a Provider Application is Deemed Incomplete, 12/09
- UD Modifier and 340B Drugs, 6/09
- Undeliverable Mail, 4/09
- Upcoming Medicaid Integrity Program – CMS Provider Audits, 2/09
- Updated EOB Code Crosswalk to HIPAA Standard Codes:
- Updates Related to National Drug Code Project, 6/09
- Urine Drug Testing, 11/09
- Use of Medicaid Provider Number After National Provider Identifier Implementation, 4/09
- Web-based Provider Enrollment Applications Available Online Beginning August 31, 2009, 8/09
Adult Care Home Providers:
Adult Day Health Care Centers:
Ambulatory Surgical Centers:
Anesthesia Providers:
Baby Love Services Providers:
All CAP Providers:
CAP/C Service Providers:
CAP/DA Service Providers:
CAP/DA Lead Agencies:
CAP/MR-DD Providers:
- Mental Health Cost Report Training Sessions:
Children's Developmental Services Agencies:
Chiropractors:
Community Care of North Carolina/Carolina ACCESS:
Dental Providers:
Dialysis Providers:
Durable Medical Providers:
- 2009 HCPCS Code Description Changes and Code Additions for Durable Medical Equipment, 2/09
- Coverage for Augmentative and Alternative Communication Devices:
- Coverage for Canes, Crutches, Walkers, and Gait
Trainers, 1/09
- Coverage for Servicing and Repairing Durable Medical Equipment, 11/09
- Coverage for Standers, 11/09
- Medically Necessary Incontinence, Ostomy, and Urological Supplies, 11/09
- Prodigy Diabetic Supplies Under the Durable Medical Equipment and Pharmacy Programs,
- Revised Clinical Coverage Criteria for External Insulin Infusion Pumps, 2/09
- Suppliers of Medicare Durable Medical Equipment, 10/09
Enhanced Behavioral Health (Community Intervention) Services Providers:
Federally Qualified Health Centers:
Health Department Dental Centers:
Health Departments:
HIV Case Management Providers:
Home Health Service Providers:
Home Infusion Therapy Providers:
Hospice Providers:
- Billing for Revenue Codes 651, 652, 655, and 658, 5/09
- Core Based Statistical Area Code Pricing Structure for Revenue Codes RC651, RC652, RC655, and RC656, 10/09
- Hospice Rate Review, 3/09
- Registration for Hospice Seminars, 5/09
Hospital Outpatient Clinics:
Hospital Psychiatric Units:
Hospitals:
Independent Diagnostic Testing Facility Providers:
Independent Laboratories:
Independent Practitioners:
Institutional (UB-04/837I) Billers:
Local Education Agencies:
Local Management Entities:
Medical Doctors:
N.C. Health Choice Providers:
Non-State-Owned ICF/MR Providers:
Nurse Midwives:
Nurse Practitioners:
- 17 Alpha Hydroxyprogestererone Caproate (17P), Injection from Bulk Powder – Billing Guideline Update, 2/09
- Antithrombin (Recombinant) for Injection (ATryn, HCPCS Procedure Code J3590): Billing Guidelines, 9/09
- Bendamustine (Treanda, HCPCS Procedure Code J9999) – Additional Diagnosis Codes, 1/09
- Bendamustine (Treanda, HCPCS Procedure Codes J9999 and J9033):
- Bevacizumab (Avastin, HCPCS Procedure Code J9035): Update to Billing Guidelines, 7/09
- Canakinumab Single-use Vials (180 mg) (Ilaris, HCPCS Code J3590): Billing Guidelines, 11/09
- Clarification of the Two-Step Tuberculosis (TB) Test Process and Billing, 12/09
- Degarelix Single-use Vials for Injection (Firmagon, HCPCS Procedure Code J3490): Billing Guidelines, 9/09
- Factor VIII (Xyntha, HCPCS Procedure Code Q2023): Billing Guidelines, 7/09
- Ferumoxytol Injection (Feraheme, HCPCS Procedure Code J3490): Billing Guidelines, 10/09
- Fibrinogen Concentrate (Human) Single-use Vials for Injection (RiaSTAP, HCPCS Procedure Code J3590): Billing Guidelines, 9/09
- Golimumab (50 mg per 0.5 ml) for Injection (Simponi, HCPCS Procedure Code J3590): Billing Guidelines:
- Infliximab (Remicase, HCPCS Code J1745) and Rituximab (Rituxan, HCPCS Code J9310): New Billing Guidelines, 11/09
- Interferon Beta-1a (Avonex, HCPCS Procedure Code Q3025): Billing Guidelines, 8/09
- Lacosamide Single-Use Vials (20 ml) for Injection (Vimpat, HCPCS Procedure Code J3490): Billing Guidelines, 7/09
- Lidocaine for Topical Anesthesia and Saline/Water Codes: Billing Guidelines, 12/09
- Oxaliplatin (Eloxatin, HCPCS Procedure Code J9263) – Additional Diagnosis Codes:
- Plerixafor, 1.2 ml Single-use Vials for Injection (Mozobil, HCPCS Procedure Code J3490):
- Rasburicase, 0.5 mg (Elitek, HCPCS Procedure Code J2783), 3/09
- Regadenson (Lexiscan) Billing Guidelines, 6/09
- Requesting an Exception to the Legislative Visit Limit, 9/09
- Sodium Fluoride F-18 (HCPCS Procedure Code A9580) - Billing Guidelines, 6/09
- Temozolomide Single-use Vials for Injection (Temodar, HCPCS Procedure Code J9999): Billing Guidelines, 9/09
- Testosterone Pellets (Testopel, HCPCS Procedure Code S0189) - Billing Guidelines, 4/09
Nursing Facilities:
OB/GYN Providers:
Optometrists:
Orthotics and Prosthetics Providers:
Osteopaths:
Outpatient Behavioral Health Service Providers:
Personal Care Service Providers:
Pharmacists:
- Addition of Dispense As Written Code "8", 6/09
- Changes to Prior Authorization Requirements for Antinarcolepsy/Antihyperkinesis Agents, 9/09
- Changes to Prior Authorization Requirements for Proton Pump Inhibitors, 9/09
- Drug Utilization Review Early Refill Alert, 12/09
- Emergency Fills for Recipients in the Focused Risk Management Program, 2/09
- Insulin Syringes, 7/09
- New Prior Authorization Requirements for Brand-name ACE Inhibitors, Angiotensin Receptor Blockers, and Renin Inhibitors, 9/09
- New Prior Authorization Requirements for Brand-name Fibrates and Lovaza, 12/09
- New Prior Authorization Requirements for Brand-name Muscle Relaxants, 8/09
- New Prior Authorization Requirements for Brand-name Nasal Steroids, 8/09
- New Prior Authorization Requirements for Leukotriene Modifiers, 11/09
- New Prior Authorization Requirements for Serotonin 5-HT1 Receptor Agonists (Triptans), 8/09
- New Prior Authorization Requirements for Short-acting Inhaled Beta Agonists, 10/09
- Pharmacy Reimbursement Changes, 10/09
- Prescription Origin Code:
- Prodigy Diabetic Supplies Under the Durable Medical Equipment and Pharmacy Programs,
- Removal of Cough and Cold Medications from Coverage, 12/09
- State Maximum Allowable Cost Changes, 10/09
- Suppliers of Medicare Durable Medical Equipment, 10/09
- Synagis Pharmacy Claims for 2008/2009 Season, 6/09
- Tacrolimus Added to the Narrow Therapeutic Index List, 6/09
Physicians:
- 17 Alpha Hydroxyprogestererone Caproate (17P), Injection from Bulk Powder – Billing Guideline Update, 2/09
- Antithrombin (Recombinant) for Injection (ATryn, HCPCS Procedure Code J3590): Billing Guidelines, 9/09
- Behavioral Health Services Provided by Provisionally Licensed Professionals in Physician Offices:
- Bendamustine (Treanda, HCPCS Procedure Code J9999) – Additional Diagnosis Codes, 1/09
- Bendamustine (Treanda, HCPCS Procedure Codes J9999 and J9033):
- Bevacizumab (Avastin, HCPCS Procedure Code J9035): Update to Billing Guidelines, 7/09
- Canakinumab Single-use Vials (180 mg) (Ilaris, HCPCS Code J3590): Billing Guidelines, 11/09
- Changes to Outpatient Specialized Therapies:
- Circumcision Updates, 10/09
- Clarification of the Two-Step Tuberculosis (TB) Test Process and Billing, 12/09
- Degarelix Single-use Vials for Injection (Firmagon, HCPCS Procedure Code J3490): Billing Guidelines, 9/09
- Factor VIII (Xyntha, HCPCS Procedure Code Q2023): Billing Guidelines, 7/09
- Ferumoxytol Injection (Feraheme, HCPCS Procedure Code J3490): Billing Guidelines, 10/09
- Fibrinogen Concentrate (Human) Single-use Vials for Injection (RiaSTAP, HCPCS Procedure Code J3590): Billing Guidelines, 9/09
- Golimumab (50 mg per 0.5 ml) for Injection (Simponi, HCPCS Procedure Code J3590): Billing Guidelines:
- Infliximab (Remicase, HCPCS Code J1745) and Rituximab (Rituxan, HCPCS Code J9310): New Billing Guidelines, 11/09
- Interferon Beta-1a (Avonex, HCPCS Procedure Code Q3025): Billing Guidelines, 8/09
- Lacosamide Single-Use Vials (20 ml) for Injection (Vimpat, HCPCS Procedure Code J3490): Billing Guidelines, 7/09
- Lidocaine for Topical Anesthesia and Saline/Water Codes: Billing Guidelines, 12/09
- Medical Risk Management Project, 3/09
- Outpatient Specialized Therapies, 9/09
- Oxaliplatin (Eloxatin, HCPCS Procedure Code J9263) – Additional Diagnosis Codes:
- Plerixafor, 1.2 ml Single-use Vials for Injection (Mozobil, HCPCS Procedure Code J3490):
- Pre-Dialysis ESRD Focused Care Study, 3/09
- Prior Authorization and Billing Guidelines for Outpatient Behavioral Health Services:
- Prior Authorization for CPT Procedure Codes 99408 and 99409 Provided by Provissionally Licensed Providers Billing "Incident To" a Physician, 7/09
- Rasburicase, 0.5 mg (Elitek, HCPCS Procedure Code J2783), 3/09
- Regadenson (Lexiscan) Billing Guidelines, 6/09
- Requesting an Exception to the Legislative Visit Limit, 9/09
- Sodium Fluoride F-18 (HCPCS Procedure Code A9580) - Billing Guidelines, 6/09
- Sterilization Consent Forms and Hysterectomy and Abortion Statements, 10/09
- Temozolomide Single-use Vials for Injection (Temodar, HCPCS Procedure Code J9999): Billing Guidelines, 9/09
- Testosterone Pellets (Testopel, HCPCS Procedure Code S0189) - Billing Guidelines, 4/09
Podiatrists:
Portable X-Ray Providers:
Prescribers:
- Changes to Prior Authorization Requirements for Antinarcolepsy/Antihyperkinesis Agents, 9/09
- Changes to Prior Authorization Requirements for Proton Pump Inhibitors, 9/09
- New Prior Authorization Requirements for Brand-name ACE Inhibitors, Angiotensin Receptor Blockers, and Renin Inhibitors, 9/09
- New Prior Authorization Requirements for Brand-name Fibrates and Lovaza, 12/09
- New Prior Authorization Requirements for Brand-name Muscle Relaxants, 8/09
- New Prior Authorization Requirements for Brand-name Nasal Steroids, 8/09
- New Prior Authorization Requirements for Leukotriene Modifiers, 11/09
- New Prior Authorization Requirements for Serotonin 5-HT1 Receptor Agonists (Triptans), 8/09
- New Prior Authorization Requirements for Short-acting Inhaled Beta Agonists, 10/09
- Removal of Cough and Cold Medications from Coverage, 12/09
- Tacrolimus Added to the Narrow Therapeutic Index List, 6/09
Private Duty Nursing Providers:
Professional Claim (CMS-1500/837P) Billers:
Psychiatric Hospitals:
Psychiatrists:
Residential Child Care Treatment Facility Providers:
Rural Health Clinics: