May 2004 Medicaid Bulletin

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In This Issue . . .

All Providers:

Adult Care Home Providers:

Area Mental Health Programs:

Clinical Nurse Specialists:

Developmental Evaluation Centers:

Durable Medical Equipment Providers:

Home Health Providers:

Hospital Outpatient Clinics:

Independent Practitioners:

Licensed Clinical Social Workers:

Licensed Psychologists:

Local Health Departments:

Maternity Care Coordinators:

Personal Care Services:

Physicians:

Private Duty Nursing Providers:

Psychiatrists:


Attention: All Providers

Billing for Medicare Part B with the CMS-1500 Claim Type

The Division of Medical Assistance (DMA) is required by the N.C. General Assembly to price claims for dually eligible (Medicare-Medicaid) recipients per Medicaid medical policy with full compliance no later than October 1, 2005. Since October 2002, Medicaid pricing for dually eligible claims has been through the secondary filing of a "Medicaid Ready" form. (Refer to the November 2002 revised draft of Special Bulletin VI, Medicare Part B Billing Guidelines.) Prior to this change, claims were paid automatically via a crossover tape from the Medicare fiscal intermediary.

Based on input from the N.C. Medical Group Managers and the N.C. Medical Society, DMA will be reinstating the automatic crossover payments for providers who bill Medicare Part B to Medicaid using the CMS-1500 claim type. "Medicaid Pricing" (as required by the General Assembly) will be achieved on these claims through the use of percentage cutbacks on the Medicare determined coinsurance amount. In most cases, the need for secondary filing will be eliminated. Upon full conversion to the new MMIS system, most claims will be able to be processed automatically using Medicaid medical policy as directed by the General Assembly.

Details regarding the transition timeline and firm implementation date for the automatic crossover are still being coordinated. Preliminary feedback indicates that the reprogramming required to accept the crossover tape will take until September. Full details will be provided in an upcoming general Medicaid bulletin.

November 2002 revised draft of Special Bulletin VI, Medicare Part B Billing Guidelines

Tim Brookshire, Financial Operations
DMA, 919-857-4015


Attention: All Providers

Checkwrite Schedule Change

The June 24, 2004 checkwrite date has changed to June 22, 2004. The electronic cut-off date for this checkwrite will remain June 18, 2004.

2004 Checkwrite Schedule

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


Attention: All Providers

Endoscopy CPT Base Codes and Their Related Procedures

The following table represents a current and updated list of covered base and related endoscopy codes as designated in the 2004 Resource Based Relative Value System (RBRVS). New codes were added to the related side for group 11.

Scopy Base and Related Code Group

Group

Base Code

Related Codes

Comments

1

29805

29806-29807, 29819-29826

 

2

29830

29834-29838

3

29840

29843-29847

4

29860

29861-29863

5

29870

29871, 29874-29877, 29879-29887

6

31505

31510-31513

7

31525

31527-31530, 31535, 31540, 31560, 31570

8

31526

31531, 31536, 31541, 31561, 31571

9

31622

31623-31625, 31628-31631, 31635, 31640-31641, 31645

 

10

43200

43201-43202, 43204-43205, 43215-43217, 43219-43220, 43226-43228

 

11

43235

43231-43232, 43236-43239, 43241-43247, 43249-43251, 43255-43256, 43258-43259

Effective 01/01/2004 new codes (43237, 43238) added to related codes

12

43260

43240, 43261-43265, 43267-43269, 43271-43272

 

13

44360

44361, 44363-44366, 44369, 44370, 44372-44373 

 

14

44376

44377-44379 

 

15

44388

44389-44394, 44397

 

16

45300

45303, 45305, 45307-45309, 45315, 45317, 45320-45321, 45327

 

17

45330

45331-45335, 45337-45340, 45345

 

18

45378

45379-45381, 45382-45387

 

19

46600

46604, 46606, 46608, 46610-46612, 46614-46615

20

47552

47553-47556

21

50551

50555, 50557, 50559, 50561 

22

50570

50572, 50574-50576, 50578, 50580 

23

50951

50953, 50955, 50957, 50959, 50961 

24

50970

50974, 50976 

25

52000

52007, 52010, 52204, 52214, 52224, 52250, 52260, 52265, 52270, 52275-52277, 52281-52283, 52285, 52290, 52300-52301, 52305, 52310, 52315, 52317-52318

 

26

52005

52320, 52325, 52327, 52330, 52332, 52334, 52341-52344 

 

27

52335

52336-52339

End-dated due to 2001 CPT update

28

56300

56301-56309, 56311, 56343-56344, 56314

End-dated due to 2000 CPT update

29

56350

56351-56356

End-dated due to 2000 CPT update

30

57452

57454-57456, 57460-57461

 

31

49320

38570, 49321-49323, 58550, 58660-58662, 58670-58671

Code 58551 end-dated 08/31/2003 due to 2003 CPT update

32

58555

58558-58563

33

52351

52345-52346, 52352-52355

34

31575

31576-31579

 

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


Attention: All Providers

Family Planning Services Billing

Effective with date of service April 26, 2004, Medicaid began requiring the use of the FP modifier and a family planning diagnosis code (V25.0 through V25.9, except for V25.3) when family planning services are provided. The FP modifier and a family planning diagnosis code (V25.0 through V25.9, except for V25.3) must be appended to the CPT or HCPCS code billed for the family planning service. Providers may receive a denial if family planning services are not clearly identified. If you receive a denial, check the claim for errors and refile.

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


Attention: All Providers

Electronic Funds Transfer Form – Fax Number Change for Submittals

The new fax number for submitting the Electronic Funds Transfer (EFT) Authorization Agreement for Automatic Deposits form to the EDS Financial Unit that was published in the April 2004 general Medicaid bulletin has now been changed to 919-816-3186.

EDS offers EFT as an alternative to paper checks. This service enables Medicaid payments to be automatically deposited in the provider’s bank account. EFT guarantees payment in a timely manner and prevents checks from being lost or stolen.

To initiate the automatic deposit process, providers are required to complete and return an EFT form. To confirm the provider’s account number and bank transit number, a voided check must be attached to the form. A separate EFT form and voided check must be submitted for each provider number. Providers must also submit a new EFT form and voided check if they change banks or bank accounts.

Completed forms may be faxed to the number listed above or mailed to the address listed on the form.

Note: Providers will continue to receive paper checks for two checkwrite periods before automatic deposit begins or resumes to a new bank account. Providers may verify that the EFT process for automatic deposit has been completed by checking the top left corner of the last page of their Remittance and Status Report, which will indicate EFT number rather than check number.

Electronic Funds Transfer Form

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


Attention: All Providers

Medicaid Credit Balance Reporting

All providers participating in the Medicaid program are required to submit to the Division of Medical Assistance (DMA), Third Party Recovery Section a quarterly Credit Balance Report indicating balances due to Medicaid. Providers must report any OUTSTANDING credits owed to Medicaid that have not been reported previously on a Medicaid Credit Balance Report. However, hospital and nursing facility providers are required to submit a report every calendar quarter even if there are no credit balances. The report must be submitted no later than 30 days following the end of the calendar quarter (March 31, June 30, September 30, and December 31).

The Medicaid Credit Balance Report is used to monitor and recover "credit balances" owed to the Medicaid program. A credit balance results from an improper or excess payment made to a provider. For example, refunds must be made to Medicaid if a provider is paid twice for the same service (e.g., by Medicaid and a medical insurance policy, by Medicare and Medicaid, by Medicaid and a liability insurance policy, if the patient liability was not reported in the billing process or if computer or billing errors occur).

For the purpose of completing the report, a Medicaid Credit Balance is the amount determined to be refundable to the Medicaid program. When a provider receives an improper or excess payment for a claim, it is reflected in the provider’s accounting records (patient accounts receivable) as a "credit." However, credit balances include money due to Medicaid regardless of its classification in a provider's accounting records. If a provider maintains a credit balance account for a stipulated period (e.g., 90 days) and then transfers the account or writes it off to a holding account, this does not relieve the provider of liability to the Medicaid program. The provider is responsible for identifying and repaying all monies owed the Medicaid program.

The Medicaid Credit Balance Report requires specific information on each credit balance on a claim-by-claim basis. The reporting form provides space for 15 claims but may be reproduced as many times as necessary to accommodate all the credit balances being reported. Specific instructions for completing the report are on the reverse side of the reporting form.

Submitting the Medicaid Credit Balance Report does not result in the credit balances automatically being reimbursed to the Medicaid program. If submitting a check is the preferred form of satisfying the credit balances, the check must be made payable to EDS and sent to EDS with the required documentation for a refund. If an adjustment is to be made to satisfy the credit balance, an adjustment form must be completed and submitted to EDS with all the supporting documentation for processing.

Submit
Medicaid Credit Balance Report Form
to:

Submit
refund checks
to:

Submit
Medicaid Claim Adjustment Request Form
to:

Third Party Recovery Section
Division of Medical Assistance
2508 Mail Service Center
Raleigh, NC 27699-2508

EDS
Refunds
P.O. Box 300011
Raleigh, NC 27622-3011

EDS
Adjustment Unit
P.O. Box 300009
Raleigh, NC 27622-3009

Submit ONLY the completed Medicaid Credit Balance Report to DMA. DO NOT send refund checks or adjustment forms to DMA. DO NOT send the Credit Balance Report to EDS.

Failure to submit a Medicaid Credit Balance Report will result in the withholding of Medicaid payments until the report is received.

Anita Ray, Third Party Recovery Section
DMA, 919-733-6294


Attention: Adult Care Home Providers

HIPAA Code Conversion for Adult Care Home Personal Care Services

To comply with the implementation of national code sets as mandated by the Health Insurance Portability and Accountability Act (HIPAA), it is necessary to end-date all N.C. Medicaid state-created codes and convert to national codes.

The following state-created procedure codes will be end-dated effective with date of service May 31, 2004:

Procedure Code

Description

W8251

Basic ACH/PC (Facility beds 1-30)

W8258

Basic ACH/PC (Facility beds 31 and above)

W8255

Enhanced ACH/PC (Ambulation/Locomotion)

W8256

Enhanced ACH/PC (Eating)

W8257

Enhanced ACH/PC (Toileting)

W8259

Enhanced ACH/PC (Eating & Toileting)

The following services must be billed using both a revenue code and the corresponding HCPCS code effective with date of service June 1, 2004:

Revenue Code

HCPCS

Description

599

T1020

Personal Care Services, per diem

229

T2002

Non-emergency Transportation, per diem

Note: Therapeutic leave is billed using revenue code 183 only. It is not necessary to bill for this service with both a revenue code and a HCPCS code.

While the claim form has not changed, HIPAA requires a diagnosis code to be included with all claim submissions. Therefore, effective with date of service June 1, 2004, providers must include the primary diagnosis code V606 (Person Living in Residential Institution) in the appropriate form locator (form locator 67 for paper claims) on the claim form.

When filing claims electronically using the NCECS-Web claims entry tool, providers will notice several new fields for data entry. With the exception of the primary diagnosis code (V606) and the bill type (893), it is not necessary to enter data in all of these new fields.

Current licensed bed information for each facility must be on file with Medicaid. Providers who have not submitted this information to the Division of Medical Assistance must do so before these changes take effect on June 1, 2004, or their claims will deny for payment. Providers with questions regarding licensed bed information may contact Demeika Dunston at 919-857-4021.

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


Attention: Area Mental Health Programs/Local Management Entities, Developmental Evaluation Centers, Independent Practitioners, Physicians, Local Health Departments, Home Health Providers, and Hospital Outpatient Clinics

Outpatient Specialized Therapies Prior Approval Process

Effective October 1, 2002, prior approval was implemented as a requirement for all outpatient treatment services for Occupational Therapy, Physical Therapy, Speech Therapy, Respiratory Therapy, and Audiological Services regardless of where the services are provided (except schools).

When providers accept an individual as a private patient, and the individual subsequently becomes Medicaid eligible, the providers, should they agree to bill Medicaid, may request prior approval from Medical Review of North Carolina (MRNC).

Retrospective prior approval may be granted for dates of service that do not precede October 1, 2002, the date that the prior approval requirement was implemented. Approval will not be granted for dates of service prior to the recipient’s effective date of eligibility.

Providers must submit all required paperwork to MRNC requesting the retroactive date as the start date. Providers must write "Retroactive Medicaid" on the prior approval form.

Retroactive Medicaid requests are reviewed by MRNC following the same process that is used for all other outpatient specialized therapy prior approval requests.

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


Attention: Durable Medical Equipment Providers

Effective Dates for HCPCS Code E0165

Based on documentation from Palmetto Government Benefits Administrators, HCPCS code E0165, "commode chair, stationary, with detachable arms" was erroneously placed on the Centers for Medicare and Medicaid Services’ list of code deletions effective January 1, 2004. Therefore, HCPCS code E0165 will be returned to the Capped Rental/Purchased Equipment category of the DME Fee Schedule effective with date of service January 1, 2004. The maximum allowable reimbursement rates are $14.78 for monthly rental, $147.78 for new purchase, and $110.84 for used purchase. The lifetime expectancy of the item is three years. This item does not require prior approval. A Certificate of Medical Necessity and Prior Approval form must be completed regardless of the requirement for prior approval. Claims for this equipment that were denied for dates of service December 31, 2003 and after may be refiled as new claims.

DME Fee Schedule

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


Attention: Personal Care Services Providers

Assignment of Provider Numbers for Personal Care Services

Personal Care Services (PCS )providers licensed by the Division of Facility Services (DFS) to provide in-home aide services are required to apply for a "site-specific" Medicaid provider number. The site-specific" provider number issued by the Division of Medical Assistance (DMA) is required in order to bill Medicaid for personal care services. If a PCS provider opens additional DFS approved and licensed business sites, DMA requires the PCS provider to submit an Application for Provider Participation for the newly added site(s).

A business site is defined as a licensed site from which the agency provides home care services or maintains client services records or advertises itself as a home care agency.

A PCS provider with only one DMA approved Medicaid provider number operating multiple DFS licensed PCS business sites, is out of compliance with Medicaid enrollment guidelines.

Providers who are out of compliance must immediately complete and submit an Application for Participation along with a copy of the DFS issued licensure for the business site location they are enrolling.

Pamela Horrell, Provider Services
DMA, 919-857-4017


Attention: Area Mental Health Programs/Local Management Entities, Clinical Nurse Specialists, Licensed Clinical Social Workers, Licensed Psychologists, and Psychiatrists

Outpatient Treatment Reports

ValueOptions has revised all of the Outpatient Treatment Report (OTR) forms into one 2-page form. The new N.C. Medicaid Behavioral Health/Substance Abuse Outpatient Treatment Report form reflects the implementation of national codes mandated by the Health Insurance Portability and Accountability Act (HIPAA).

The new form and step-by-step instructions for completing the form can be downloaded from ValueOptions’ website at http://www.valueoptions.com/provider/handbooks/forms.htm under the heading Outpatient Treatment Report (OTR).

Outpatient Treatment Report

ValueOptions, 1-888-510-1150


Attention: Personal Care Services and Private Duty Nursing Providers

Code Conversion and Claim Form Changes

Effective with date of service August 1, 2004, Personal Care Services (PCS), PCS-Plus, and Private Duty Nursing (PDN) providers will begin billing for services using the CMS-1500 claim form with the national codes listed below. This change is being made to comply with the implementation of national codes mandated by the Health Insurance Portability and Accountability Act (HIPAA).

Note: Providers must continue to bill for dates of service prior to August 1, 2004 using the UB-92 claim form.

 

PCS

PCS-Plus

PDN

Prior to August 1, 2004

RC599

RC599

RC590

Effective August 1, 2004

S5125

99509

T1000

 

Effective with date of service August 1, 2004, PDN providers will also begin billing home health supplies using the CMS-1500 claim form with the appropriate HCPCS codes only.

Detailed billing guidelines will be published in the June 2004 Special Bulletin II, Personal Care Services and Personal Care Services-Plus Program Billing Guide, and the June 2004 Special Bulletin III, Private Duty Nursing Program Billing Guide.

Seminars focusing on the new billing guidelines are scheduled for June 2004.

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


Attention: Maternity Care Coordinators

Maternity Care Services Seminars

Seminars for Maternity Care Services are scheduled for July 2004. Attendance is mandatory for both current and new maternity care coordinators due to the implementation of new policy guidelines. The registration form and a list of site locations for the seminars will be published in the June 2004 general Medicaid bulletin.

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


Attention: All Providers

General Medicaid Billing Seminar Schedule

General Medicaid Billing seminars are scheduled for June 2004. Seminars are intended for providers who are new to the N.C. Medicaid program. Topics to be discussed will include, but are not limited to, provider enrollment requirements, billing instructions, eligibility issues, and Managed Care. Persons inexperienced in billing N.C. Medicaid are encouraged to attend.

The seminars are scheduled at the locations listed below. Preregistration is required. Due to limited seating, registration is limited to two staff members per office. Unregistered providers are welcome to attend if space is available.

The 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. Lunch will not be served.

Providers may register for the General Medicaid Billing seminars by completing and submitting the General Medicaid Billing Seminar registration form or through online registration. Please indicate on the registration form the session you plan to attend.

Providers must print the PDF version of the May 2004 General Medicaid Billing/Carolina ACCESS Policies and Procedures Guide and bring it to the seminar.

Seminar Location

Tuesday, June 8, 2004
Jane S. McKimmon Center
1101 Gorman Street
Raleigh, NC

 

Wednesday, June 9, 2004
Holiday Inn Conference Center
530 Jake Alexander Blvd., S.
Salisbury, NC

Wednesday, June 16, 2004
Blue Ridge Community College
Bo Thomas Auditorium
College Drive
Flat Rock, NC

Thursday, June 17, 2004
Ramada Inn Plaza
3050 University Parkway
Winston-Salem, NC

 

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


Directions to the General Medicaid Billing Seminars

Jane S. McKimmon Center – Raleigh

Holiday Inn Conference Center – Salisbury

Blue Ridge Community College, Bo Thomas Auditorium – Flat Rock

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. Take the first right-hand turn into the parking lot for the Bo Thomas Auditorium.

Ramada Inn Plaza – Winston-Salem

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.


Attention: All Providers

Medicaid Family Planning Waiver Seminar and Teleconference Schedule

On July 1, 2004, the N.C. Medicaid program will implement the new Medicaid Family Planning Waiver program. The program is designed to reduce unintended pregnancies and to improve the well being of children and families in North Carolina by providing family planning services to eligible men and women.

Seminars and teleconferences on the Waiver program are scheduled for June 2004 and July 2004 and will focus on recipient eligibility, covered services, and billing for family planning services covered through the Waiver program.

Preregistration for the seminars and the teleconferences is required. Due to limited seating, registration is limited to two staff members per office. Unregistered providers are welcome to attend if space is available.

The 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. Two teleconference sessions will be available on each of the days that the teleconferences are scheduled. Providers may choose to attend either the morning session or the afternoon session. The morning session begins at 8:30 a.m. and ends at 12:00 p.m. Providers are encouraged to arrive by 8:15 a.m. to complete registration. The afternoon session begins at 1:00 p.m. and ends at 4:30 p.m. Providers are encouraged to arrive by 12:45 p.m. to complete registration. Lunch will not be provided at the seminars or the teleconferences.

Providers may register for the seminars or for the teleconference by completing and submitting the Medicaid Family Planning Waiver registration form or through online registration. Please indicate on the registration form the session you plan to attend.

Providers must print the PDF version of the June 2004 Special Bulletin IV, Medicaid Family Planning Waiver Program Billing Guidelines and bring it to the seminar. The special bulletin will be available online beginning June 1, 2004.

Seminar Locations

Monday, June 7, 2004
WakeMed
Andrews Conference Center
3000 New Bern Ave.
Raleigh, NC

Tuesday, June 29, 2004
Holiday Inn Conference Center
530 Jake Alexander Blvd. S.
Salisbury, NC

 

Wednesday, June 30, 2004
Bo Thomas Auditorium
Blue Ridge Community College
College Dr.
Flat Rock, NC

 

 

Teleconference Locations

The teleconference is accessible from each of the sites listed below on June 10, 2004 and July 12, 2004.

Albemarle Regional Health Services
711 Roanoke Avenue
Elizabeth City, NC

Catawba County Health Department
3070 11th Avenue Drive, SE
Hickory, NC

Cooper Building
Dawson Street
Raleigh, NC

Cumberland County Health Department
E. Newton Smith Public Health Center
227 Fountainhead Lane
Fayetteville, NC

Jackson County Health Department
Community Services Building
538 Scotts Creek Road, Suite 100
Sylva, NC

UNC School of Public Health
W.F. Mayes Center
231-B Rosenau Hall
Chapel Hill, NC

Wilson County Health Department
1801 Glendale Drive
Wilson, NC

 

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


Directions to the Medicaid Family Planning Waiver Seminars

WakeMed Andrews Conference Center – Raleigh

Holiday Inn Conference Center – Salisbury

Blue Ridge Community College, Bo Thomas Auditorium – Flat Rock

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. Take the first right-hand turn into the parking lot for the Bo Thomas Auditorium.


Directions to the Medicaid Family Planning Waiver Teleconference Sites

 

Albemarle Regional Health Services – Elizabeth City

Take US 17 north to Elizabeth City. Take US 17 Business (Ehringhaus Street) to Halstead Boulevard (beside Burger King). Turn right on Halstead Boulevard and travel approximately ¾ miles to Roanoke Avenue. Turn left onto Roanoke Avenue and travel approximately ½ mile. The Albemarle Regional Health Services building is located on the right.

Catawba County Health Department – Hickory

Take I-40 to Hickory. Take Exit 128 onto Fairgrove Church Street. Travel approximately ¾ miles to the second stoplight. Turn left onto Eleventh Avenue Drive. The Catawba County Health Department is located on the right just past the Catawba Memorial Hospital. Parking is available in the first parking lot in front of the building. Teleconference room 117 is located at the end of the first hallway on the right.

Cooper Building – Raleigh

E. Newton Smith Public Health Center, Cumberland County Health Department – Fayetteville

Community Services Building, Jackson County Health Department – Sylva

From Asheville, take I-40 west to Waynesville. From Waynesville, take US 19/US 23 South/US 74 West to Sylva. Take exit 78. Travel approximately 3 miles to Harris Regional Hospital and turn right. Travel approximately ½ miles to the Community Services Building on the right. The teleconference center is located in the brown colonial-style modular unit beside the main building.

W.F. Mayes Center, UNC-Chapel Hill – Chapel Hill

Take I-40 to Chapel Hill. Exit onto NC 54 West, exit 273-B. Travel west on NC 54. At the NC 54 Business/Bypass split, NC 54 becomes Raleigh Road. Follow Raleigh Road onto the University campus. At the top of the hill, after the intersection of Raleigh Road and County Club Road, the road changes names to South Road. Follow South Road through the campus. After crossing S. Columbia Street, turn left onto Pittsboro Street. Travel past the Tate-Turner-Kuralt Building on the left, then past McGavran-Greenberg Hall. Be ready to bear to the left – there’s a stoplight – and to recross S. Columbia Street onto Manning Drive. Travel on Manning Drive to the second stoplight. Turn right onto East Drive.

Paid parking ($.75 per hour) is available on the Dogwood Deck of the visitor’s parking lot. The parking lot entrance is located to the right on East Drive.

To reach the Mayes Center, walk back to Manning Drive. Turn left onto Manning Drive. Turn right onto S. Columbia Street. Rosenau Hall is located to the left at the top of the hill. The Mayes Center is located on the second floor of Rosenau Hall in room 231.

Wilson County Health Department – Wilson

Take US 264 east to Wilson. After crossing I-95, turn at the third stoplight onto Forest Hill Road. Turn left at the second stoplight onto Tarboro Street. Turn right at the first stoplight onto Glendale Drive. The Wilson County Health Department is located immediately after the next stoplight. Turn into the second drive after the stoplight. Enter the building through the doors under the blue awning. The teleconference room is located on the right.


Attention: Personal Care Services Providers and Private Duty Nursing Providers

Personal Care Services and Private Duty Nursing Program Seminar Schedule

Seminars for the Personal Care Services (PCS) and Private Duty Nursing (PDN) providers are scheduled for June 2004. The seminars will focus on changes in billing codes and the conversion to billing on the CMS-1500 claim form. Billing electronically using NCECS-Web will also be discussed. Policy guidelines for the PCS and PDN programs will not be covered in these seminars.

Note: These seminars are not intended for Adult Care Home PCS.

The seminars are scheduled at the locations listed below. Preregistration is required. Due to limited seating, registration is limited to two staff members per office. Unregistered providers are welcome to attend if space is available.

The 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. Lunch will not be provided at the seminars.

Providers may register for the seminars by completing and submitting the Personal Care Services and Private Duty Nursing Seminar registration form or through online registration. Please indicate on the registration form the session you plan to attend.

PCS providers must print the PDF version of the June 2004 Special Bulletin II, Personal Care Services Program and Personal Care Services-Plus Billing Guide and bring it to the seminar. The special bulletin will be available online beginning June 1, 2004.

PDN providers must print the PDF version of the June 2004 Special Bulletin III, Private Duty Nursing Program Billing Guide and bring it to the seminar. The special bulletin will be available online beginning June 1, 2004.

 

Tuesday, June 22, 2004
Jane S. McKimmon Center
1101 Gorman Street
Raleigh, NC

Wednesday, June 23, 2004
Coast Line Convention Center
501 Nutt Street
Wilmington, NC

 

Tuesday, June 29, 2004
Blue Ridge Community College
Bo Thomas Auditorium
College Drive
Flat Rock, NC

Wednesday, June 30, 2004
Ramada Inn Plaza
3050 University Parkway
Winston-Salem, NC

 

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


Directions to the Personal Care Services and Private Duty Nursing Program Seminars

Jane S. McKimmon Center – Raleigh

Coast Line Convention Center – Wilmington

Take I-40 east to Wilmington. Take the US 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.

Blue Ridge Community College, Bo Thomas Auditorium – Flat Rock

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. Take the first right-hand turn into the parking lot for the Bo Thomas Auditorium.

Ramada Inn Plaza – Winston-Salem

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.


Holiday Schedule

The Division of Medical Assistance and EDS will be closed on Monday, May 31, 2004 in observance of Memorial Day.


Proposed Medical Coverage Policies

In accordance with Session Law 2003-284, 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 Creech
Division of Medical Assistance
Medical Policy Section
2501 Mail Service Center
Raleigh, NC 27699-2501

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.


Checkwrite Schedule

May 4, 2004

June 8, 2004

July 12, 2004

May 11, 2004

June 15, 2004

July 20, 2004

May 18, 2004

June 22, 2004

July 29, 2004

May 27, 2004

June 29, 2004

 

Electronic Cut-Off Schedule

May 7, 2004

June 4, 2004

July 9, 2004

May 14, 2004

June 11, 2004

July 16, 2004

May 21, 2004

June 18, 2004

July 23, 2004

 

June 25, 2004

 

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.

2004 Checkwrite Schedule


 

_____________________
_____________________
Gary H. Fuquay, Director
Patricia MacTaggart
Division of Medical Assitance
Executive Director
Department of Health and Human Services
EDS

 

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