2004 Medicaid Bulletin Index
Medicaid bulletin articles and special bulletins organized by provider type for 2004.
All Providers:
- About ACS, 7/04
- Automated Voice Response System Instructions, 12/04
- Billing for Medicare Part B with the CMS-1500
Claim Type, 5/04
- Billing Guidelines for ICD-9-CM Diagnosis,
10/04
- Change in Billilng Requirements for Anesthesia
Codes 01961, 01968, and 01969, 9/04
- Checkwrite Schedule Change:
- Checkwrite Schedule Reminder, 12/04
- Claim Adjustments for Physician, Laboratory,
and Independent Mental Health Procedure Codes, 3/04
- Clinical Coverage Policies:
- Clinical Laboratory Improvements Amendment, 2/04
- Clinical Laboratory Improvements Amendment Certification Number Requirements, 2/04
- Clinical Policy and Programs, 9/04
- Contacting EDS Providers Services and Electronic
Commerce Services, 12/04
- Contract Awarded for Medicaid Fiscal
Agent Services, 6/04
- Corrected 1099 Requests: Action Required by March 1, 2004:
- CPT Code Update 2004, 1/04
- Directions to the Expansion of Provider Types for Outpatient Behavioral Health Services Seminars, 11/04
- EDS Address List, 9/04
- Electronic Adjustments, 12/04
- Electronic Funds Transfer Form - Fax Number Change for Submittals
- Endoscopy CPT Base Codes and Their Related
Procedures, 5/04
- EOB Code Crosswalk to HIPAA Standard Codes,
1/04
- Family Planning Services Billing, 5/04
- FluMist Influenza Vaccine (CPT Code 90660)
– Billing Guidelines, 1/04
- General Medicaid Billing Seminars:
- Hepatitis A and Hepatitis B Vaccine, Adult
Dosage, for Intramuscular Use (CPT Code 90636, 1 ml, Twinrix) Coverage Criteria,
3/04
- ICD-9-CM Code Changes for 2004, 1/04
- Inpatient Hospital Claims, 1/04
- Influenza - New Diagnosis Code for the Need
for Vaccination Against Influenza, 3/04
- Influenza – New Diagnosis Code V04.81,
1/04
- Influenza Vaccine Coverage, 11/04
- Influenza Vaccine Coverage - Billing Guidelines,
12/04
- Medicaid Credit Balance Reporting, 5/04
- Medicaid Denial of Medicare Covered Services,
6/04
- Medicaid Denial of Medicare Part B Covered
Services, 7/04
- Medicaid Family Planning Waiver Seminar
and Teleconference Schedule:
- Medical Coverage Policies:
- Medicare Crossovers:
- Medicare Override and Medicare Payment on
UB92 Claims, 12/04
- Medicare Part B Billing, Special Bulletin V, August 2004
- NCLeads Update, 10/04
- NCMMIS Update:
- New Managed Care Consultant Regions,
10/04
- New Telephone Number for Claims Analysis
Unit, 6/04
- Optional Sixth Dose of Synagis for the
2003-04 RSV Season for Previously Approved Infants, 3/04
- Payment Accuracy Measurement Project for
2004-05, 3/04
- Physician's Drug Program Changes, 3/04
- Positron Emission Tomography Scans - Billing
Guidelines, 4/04
- Provider Participation Exclusions, 12/04
- Referrals and Service Coordination for
the Community Alternatives Program for Disabled Adults, 2/04
- Refiling Denied 2003 New CPT Codes, 2/04
- Remittance and Status Report Changes
for Medicare Primary Claims, 10/04
- Resubmission of a Previously Denied Claim,
7/04
- Revised Rates for 2004 CPT Codes, 4/04
- Tax Identification Information, 12/04
- The New NCMMIS Committment to North Carolina Providers, 9/04
- Updated EOB Code Crosswalk to HIPAA Standard Codes:
- West Nile Virus (and Other Arboviral Infections),
6/04
Adult Care Home Providers:
Ambulatory Surgical Centers:
Anesthesiologists:
Area Mental Health Programs:
- Clarification for Seminar Attendees, 12/04
- End-Dated HCPCS Code for Behavioral Health ,
1/04
- HIPAA Code Conversion Clarification, 2/04
- Medicaid Determination of Eligibility
for New CAP-MR/DD Recipients, 9/04
- Outpatient Specialized Therapies Prior Approval
Process, 5/04
- Outpatient Treatment Reports, 5/04
- Prior Approval and Medicare, 10/04
- Risperidone (Risperdal Consta, J3490) –
Billing Guidelines, 1/04
- Submission of MR-2 for Level of Care
Determination, 9/04
Certified Registered Nurse Anesthetists:
Children’s Developmental Service Agencies:
Chiropractors:
Clinical Nurse Specialists:
CMS-1500 Billers:
Community Alternatives Program Case Managers and Providers:
Community Alternatives Program for Children:
Community Alternatives Program for Individuals with Mental Retardation/Developmental Disabilities:
Dental Providers
- 2002 American Dental Association
(ADA) Claim Form, 10/04
- ADA Code Updates, 11/04
- Billing for Dental Procedure Codes D7270,
D7280, and D7971, 7/04
- Conversion from CPT to CDT-4 Codes:
- Dental Services Coverage
Policy and Billing Guidelines, Special Bulletin, September 2004
- Dental Seminar Schedule:
- DMA's Dental Program Website, 11/04
- Handwritten Service Review Numbers on Prior
Approval Forms, 7/04
- New Guidelines for Enrollment:
- Provider Enrollment Directly
through DMA, 10/04
- Surgery of the Lingual Frenulum, 4/04
Developmental Evaluation Centers:
Dialysis Treatment Facility Providers:
Durable Medical Equipment Providers:
- Addition of Code E0760, Ultrasonic Osteogenesis
Stimulator to DME Fee Schedule, 2/04
- Addition of HCPCS Code E1161 to the DME Fee
Schedule, 8/04
- Addition to Medical Coverage Policy #5,
Durable Medical Equipment, 3/04
- Conversion to National Miscellaneous
Codes, 1/04
- Effective Dates for HCPCS Code E0165, 5/04
- End-dated HCPCS Codes for Orthotics
and Prosthetics, 1/04
- FROM and TO Dates for DME-Related Supplies,
6/04
- HCPCS Code Changes for DME, 1/04
- HCPCS Code Changes for Orthotics and Prosthetics,
1/04
- HCPCS Code Conversions for
Wheelchair Seat Frames and Cushions, 10/04
- HCPCS Code Conversions from A4323 and K0409
to A4217, 11/04
- HCPCS Code Conversions
from B4084 to B4086, 10/04
- HCPCS Code Deletions for DME, 1/04
- National Miscellandous HCPCS Codes, 3/04
- Place of Service for DME, 1/04
Early Intervention Service Providers:
Enhanced Behavioral Health (Community Intervention) Services Providers:
Federally Qualified Health Centers:
- Arsenic Trioxide, 1mg (Trisenox, J9017)
– Billing Guidelines, 1/04
- Intrauterine Devices Billable on the CMS-1500
Claim Form - Reimbursement Rates, 6/04
- Maternal Outreach Worker Services - Revised
Billing Guidelines, 7/04
- Medicare Part B Crossovers,
10/04
- Omalizumab (Xolair, J3490) – Billing Guidelines,
1/04
- Palonosetron 0.25 mg (Aloxi, J3490) – Billing
Guidelines, 1/04
- Risperidone (Risperdal Consta, J3490) –
Billing Guidelines, 1/04
- Use of the FP Modifier for
Family Planning Services, 10/04
Health Check Providers:
Health Department Dental Clinics:
Health Departments:
- Arsenic Trioxide, 1mg (Trisenox, J9017)
– Billing Guidelines, 1/04
- Breast and Cervical Cancer Medicaid Procedures,
1/04
- Clarification for Seminar Attendees, 12/04
- Health Check Billing Guide 2004, Special Bulletin I, April 2004
- Intrauterine Devices Billable on the CMS-1500
Claim Form - Reimbursement Rates, 6/04
- Maternal Outreach Worker Services - Revised Billing Guidelines, 7/04
- Omalizumab (Xolair, J3490) – Billing Guidelines,
1/04
- Outpatient Specialized Therapies Prior Approval
Process, 5/04
- Palonosetron 0.25 mg (Aloxi, J3490) – Billing
Guidelines, 1/04
- Risperidone (Risperdal Consta, J3490) –
Billing Guidelines, 1/04
- Training for Local Health Departments
on Changes in Health Check Requirements and Billing, 4/04
Hearing Aid Providers:
Home Health Agencies:
Home Infusion Therapy Providers:
Hospice Providers:
Hospital Outpatient Clinics:
Hospitals:
- Billing for Anesthesia Services Using Anesthesia
Modifiers, 4/04
- Correct Billing of Inpatient Hospital Transfers,
8/04
- Deflux Injectable Gel for the Treatment
of Standard Vesicoureteral Reflux - Coverage Notice, 8/04
- Emergency Services for Undocumented
Aliens, 10/04
- Essure Permanent Sterilization Procedure
- Coverage Notice, 8/04
- Lower Level of Care Bed Billing,
10/04
- Medicaid Cost Reports, 3/04
- Outpatient Observation Charges for Hysterectomies,
11/04
- Patient Status Codes - Frequently Asked
Questions, 6/04
- Stem Cell Transplants-Prior Approval Effective
Dates, 11/04
Independent Laboratories:
Independent Practitioners:
Laboratory Services:
Licensed Clinical Social Workers:
Licensed Psychologists:
Local Education Agencies:
Local Management Entities:
Maternity Care Coordinators:
Nurse Midwives:
Nurse Practitioners:
- Arsenic Trioxide, 1mg (Trisenox, J9017)
– Billing Guidelines, 1/04
- Azacitidine, 25mg (Vidaza, HCPCS
Code J9999) Billing Guidelines, 10/04
- Bevacizumab (Avastin, J9999) - Billing Guidelines,
6/04
- Cetuximab (Erbitux, J9999) - Billing Guidelines,
6/04
- Gemtuzumab Ozogamicin, 5mg (Mylotarg,
J9300) Billing Guidelines, 10/04
- Intrauterine Devices Billable on the CMS-1500
Claim Form - Reimbursement Rates, 6/04
- Omalizumab (Xolair, J3490) – Billing Guidelines,
1/04
- Palonosetron 0.25 mg (Aloxi, J3490) – Billing
Guidelines, 1/04
- Pemetrexed (Alimta, J9999) - Billing Guidelines,
6/04
- Risperidone (Risperdal Consta, J3490) –
Billing Guidelines, 1/04
Nursing Facility Providers:
- A Reminder about Retroactive Prior Approval,
2/04
- Correction to Instructions for Obtaining Retroactive
Prior Approval, 3/04
- MDS Validation Program Correction, 12/04
- Medical Data Sets Validation Program
for Nursing Facilities, 11/04
- Minimum Data Set Validation Program for Nursing
Facilities, 12/04
- Nursing Facility Level of Care Billing, 8/04
- Nursing Facility Rate Change, 6/04
- Nursing Home Denial Codes, 12/04
- Retroactive Prior Approval, 6/04
- Therapeutic Leave, 10/04
OB/GYN Providers:
Optical Service Providers:
Optometrists:
Osteopaths:
Outpatient Behavioral Health Providers:
Personal Care Services:
- Assignment of Provider Numbers for
Personal Care Services, 5/04
- Code Conversion and Claim Form Changes,
5/04
- PCS and PCS-Plus Recoupments, 10/04
- Personal Care Services and Private
Duty Nursing Program Seminar Schedule, 5/04
- Reimbursement Rate Increase for
Personal Care Services, 9/04
- Seminars for PCS, PCS-Plus, and Private
Duty Nursing Services, 4/04
- Personal Care Services and PCS-Plus Program
Billing Guide, Special Bulletin II, June 2004
Pharmacists:
- Cialis, 2/04
- Discontinuation of Coverage for Anorexia, Weight, Loss, and Weight Gain Products and Medications, 11/04
- Discontinuation of Coverage for Vioxx, 11/04
- Medical Necessity Criteria for Approval of Oxycontin, 11/04
- Medical Necessity Criteria for Approval of Provigil, 11/04
- Removal of ADHD Drugs and Rebetron from
the Prior Authorization Drug List, 9/04
- Removal of Smoking Cessation Medications and Products from the Prior Authorization Drug List, 11/04
- Revised Criteria 1a through 1d Synagis Form, 11/04
- Synagis and Respigam Forms, 10/04
- Synagis Coverage for 2004-2005, 9/04
- Technical Correction to General Policy
for Over the Counter Medications, 9/04
Physicians:
- Arsenic Trioxide, 1mg (Trisenox, J9017)
– Billing Guidelines , 1/04
- Azacitidine, 25mg (Vidaza, HCPCS
Code J9999) Billing Guidelines, 10/04
- Bevacizumab (Avastin, J9999) - Billing Guidelines,
6/04
- Billing for Ocular Photodynamic Therapy with
Verteporfin, 4/04
- Breast and Cervical Cancer Medicaid Procedures,
1/04
- Cetuximab (Erbitux, J9999) - Billing Guidelines,
6/04
- Clarification for Seminar Attendees, 12/04
- Coverage of New HCPCS "G" Codes
for End-Stage Renal Disease Related Services, 7/04
- Deflux Injectable Gel for the Treatment
of Standard Vesicoureteral Reflux - Coverage Notice, 8/04
- Essure Permanent Sterilization Procedure
- Coverage Notice, 8/04
- Gemtuzumab Ozogamicin, 5mg (Mylotarg,
J9300) Billing Guidelines, 10/04
- HCPCS Code Changes for the Physicians
Drug Program, 10/04
- Intrauterine Devices Billable on the CMS-1500
Claim Form - Reimbursement Rates, 6/04
- New Guidelines for Enrollment:
- Ocular Photodynamic Therapy with Verteporfin
- Revised Billing Guidelines, 7/04
- Omalizumab (Xolair, J3490) – Billing Guidelines,
1/04
- Outpatient Observation Charges for Hysterectomies,
11/04
- Outpatient Specialized Therapies Prior Approval
Process, 5/04
- Palonosetron 0.25 mg (Aloxi, J3490) – Billing
Guidelines, 1/04
- Pemetrexed (Alimta, J9999) - Billing Guidelines,
6/04
- Physician Management of ESRD
- Code Changes and Billing Guidelines for CMS-1500, 10/04
- Physician's Drug Program List Update
- Prior Approval and Medicare, 10/04
- Provider Enrollment Directly
through DMA, 10/04
- Risperidone (Risperdal Consta, J3490) –
Billing Guidelines, 1/04
- Stem Cell Transplants-Prior Approval Effective
Dates, 11/04
- Synagis Coverage for 2004-2005, 9/04
- Surgery of the Lingual Frenulum, 4/04
Podiatrists:
Prescribers:
- Cialis, 2/04
- Discontinuation of Coverage for Anorexia,
Weight, Loss, and Weight Gain Products and Medications, 11/04
- Discontinuation of Coverage for Vioxx, 11/04
- Medical Necessity Criteria for Approval of
Oxycontin, 11/04
- Medical Necessity Criteria for Approval
of Provigil, 11/04
- Removal of ADHD Drugs and Rebetron from the Prior Authorization Drug List, 09/04
- Removal of Smoking Cessation Medications
and Products from the Prior Authorization Drug List, 11/04
- Revised Criteria 1a through 1d Synagis Form,
11/04
- Synagis and Respigam Forms, 10/04
- Technical Correction to General Policy
for Over the Counter Medications, 9/04
Private Duty Nursing Services:
Psychiatrists:
Rural Health Clinics:
- Arsenic Trioxide, 1mg (Trisenox, J9017)
– Billing Guidelines, 1/04
- Intrauterine Devices Billable on the CMS-1500
Claim Form - Reimbursement Rates, 6/04
- Maternal Outreach Worker Services - Revised
Billing Guidelines, 7/04
- Medicare Part B Crossovers,
10/04
- Negative Reimbursement Amounts on Medicare
Remittance Advices, 12/04
- Omalizumab (Xolair, J3490) – Billing Guidelines,
1/04
- Palonosetron 0.25 mg (Aloxi, J3490) – Billing
Guidelines, 1/04
- Risperidone (Risperdal Consta, J3490) –
Billing Guidelines, 1/04
- Use of the FP Modifier for
Family Planning Services, 10/04
Swing Beds and Lower Levels of Care Providers: