2005 Medicaid Bulletin Index
Medicaid bulletin articles and special bulletins organized by provider type for 2005.
All Providers:
- Additions to Covered Diagnostic and Therapeutic Radiopharmaceuticals, 11/05
- Ambulatory Visits and Diagnosis Code V82.9, 1/05
- Basic Medicaid Billing Seminar Schedule, 1/05
- CAP/Choice – A Pilot Program of Consumer Directed Care, 1/05
- CPT Code Update 2005, 1/05
- CPT Codes 90465 and 90466 - New Immunization Administration Codes for Recipients under Eight Years of Age, 7/05
- Change in Medicaid Co-payments, 10/05
- Claim Adjustments for Physician, Laboratory, and Independent Mental Health Procedure Codes:
- Clinical Coverage Policies:
- Code Changes for Radiopharmaceuticals, 1/05
- Compliance Date for HIPAA Electronic Transactions:
- Compression Garments:
- Corrected 1099 Requests – Action Required by March 1, 2005, 1/05
- Corrected 1099 Requests - Action Required by March 1, 2006, 10/05
- Coverage of Orthotic and Prosthetic Devices, 8/05
- Decavac -
Coverage in the UCVDP/VFC Program and Billing Guidelines
, 12/05
- Directions to the OB/GYN Medicaid Billing Seminar:
- Directions to the Basic Medicaid Seminars, 1/05
- Directions to the Expansion of Provider Types for Outpatient Behavioral Health Services, 1/05
- Directions to the Medicaid Family Planning Waiver Seminar, 10/05
- Early and Periodic Screening, Diagnosis, and Treatment:
- Early and Periodic Screening, Diagnosis, and Treatment and Health Check, Special Bulletin, December 2005
- Facts for Providers Regarding the Medicare Prescription Drug Plan, 5/05
- Family Planning Waiver August 2005 Special Bulletin Update, 12/05
- Family Planning Waiver Seminar Schedule:
- Fee Schedule, 3/05
- HCPCS Code A4570 - Splint, 7/05
- HIPP Program, 12/05
- Influenza Vaccine Coverage and Reimbursement Guidelines:
- Informed Decisions Beneficiary Centered Enrollment Service, 12/05
- Intracranial Neurostimulator Procedures
(61850-61888) Covered ICD-9-CM Codes
, 10/05
- Low Osmolar Contrast Media - Billing Guidelines, 11/05
- Medicaid Coverage Information for the Excluded Drug Classes under Medicare Part D, 12/05
- Medicaid Provider Survey - Provider Input Requested:
- Medicare Part D Web Page, 11/05
- Meningococcal Conjugate Vaccine, MCV4, Billing Guidelines
8/05
- Meningococcal Conjugate Vaccine, MCV4, Coverage in the UCVDP/VFC Program and Billing Guidelines,
2/05
- Modifier Additions for 2005, 1/05
- NC Leads Updat2, 2/05
- New Health Plan Announcement, 01/05
- North Carolina Health Choice Children Age 0-5 Moving to Medicaid:
- North Carolina Health Choice Children Age 0-5 Moving to Medicaid, Special Bulletin, December 2005
- OB/GYN Medicaid Billing Seminar Schedule, 10/05
- Obstetric Anesthesia Code Limitation Change, 9/05
- Pediarix - Coverage in the UCVDP/VFC Program and Billing Guidelines, 6/05
- Piedmont Cardinal Health Plan, 3/05
- Place of Service Codes, 12/05
- Provider Services and Enrollment Change of Address, 6/05
- Provision of Orthotic and Prosthetic Devices, 5/05
- Radiation Treatment Delivery and Management Codes Billing Guidelines, 4/05
- Referrals to Adult Care Homes, 7/05
- Reimbursement Rate and HCPCS Code Changes for the Physician's Drug Program, 2/05
- Reinstating Providers Suspended for Outstanding Repayments, 12/05
- Revised Fees 2005, 1/05
- Seminar Schedule for the Expansion of Provider Types for Outpatient Behavioral Health Services, 1/05
- Seniors Health Insurance Information Program (SHIIP) "Train the Trainer" Sessions for Medicare Part D Prescription Drug Benefit, 11/05
- Sincalide (Kinevac) Coverage, 4/05
- Tax Identification Information:
- Transcranial Doppler Studies
(CPT Codes 93886 – 93893) Covered ICD-9-CM Diagnosis Codes, 9/05
- Updated EOB Code Crosswalk to HIPAA Standard Codes:
Adult Care Home Providers:
Ambulance Providers:
Ambulatory Surgical Centers:
Anesthesiologists:
Automated Quality and Utilization Improvement Program (AQUIP) Users:
Case Management Agencies:
All CAP Providers and Case Managers:
CAP/AIDS Service Providers:
CAP/C Service Providers:
CAP/DA Lead Agencies:
CAP/DA Service Providers:
CAP/MR-DD Service Providers:
Certified Registered Nurse Anesthetists:
Child Service Coordination Providers:
Children's Developmental Service Agencies:
Chiropractors:
County Departments of Social Services:
Dental Providers:
Dialysis Facilities:
Durable Medical Equipment Providers:
- 2005 HCPCS Code Deletions and Crosswalks, 2/05
- Change in Rate Methodology for HCPCS Code E0781, 10/05
- Code Conversion for Blood Glucose Monitor with Special Features, 9/05
- Code Conversions for Power Wheelchair Electronics, Wheelchair Components, and Enteral Nutrition Products, 6/05
- Correction Fluid and Correction Tape on CMN/PA Forms, 4/05
- Correction to July 2005 Code Conversions for Power Wheelchair Electronics, Wheelchair Components, and Enteral Nutrition Products, 9/05
- Enteral Nutrition HCPCS Codes Rate Change, 4/05
- HCPCS Code Changes for Pediatric Enteral Nurtition Products, 2/05
- HCPCS Code Description Changes for 2005 for Durable Medical Equipment Enteral Nutrition Products, 2/05
- HCPCS Code Conversions for Orthotic Devices, 1/05
- HCPCS Codes L2435, L5674, and L5675, 3/05
- Limitations on Medicaid Services Provided to Hospice Recipients - Clarification of Policy, 8/05
- Medicare Crossovers and Spanning Dates, 6/05
- New Certificate of Medical Necessity and Prior Approval (CMN/PA) Forms, 7/05
- Orthotic and Prosthetic Code Changes, 6/05
- Place of Service for Durable Medical Equipment and Orthotic and Prosthetic Devices, 12/05
- Reimbursement Rate for HCPCS Code A4259, Lancets, 11/05
Enhanced Behavioral Health Services:
Family Planning Services Providers:
Federally Qualified Health Centers:
Health Check Providers:
Health Choice Providers:
- Reimbursement Rate Changes:
Health Departments:
- Clarification of First Treatment for Outpatient Specialized Therapies, 9/05
- Direct Enrollment for Outpatient Behavioral Services, 5/05
- Expansion of Provider Types for Outpatient Behavioral Health Services, Special Bulletin I, January 2005
- Expansion of Provider Types for Outpatient Behavioral Health Services, Phase II, Special Bulletin IV, May 2005
- Outpatient Behavioral Health Services, 8/05
- Rates for New Immunization Codes, 7/05
- Revision to Rates for Specific Services, 7/05
- Seminar Schedule for the Expansion of Provider Types for Outpatient Behavioral Health Services, 5/05
- Training for Local Health Departments on Health Check Requirements, 4/05
- Updates to Outpatient Specialized Therapies Prior Approval Process, 7/05
Home Health Agencies:
Home Infusion Therapy:
Hospice Providers:
Hospital Outpatient Clinics:
- Clarification of First Treatment for Outpatient Specialized Therapies, 9/05
- Correction to Billing Information for Dually Eligible Medicare/Medicaid Recipients Printed in the August 2005 General Bulletin, 9/05
- Direct Enrollment for Outpatient Behavioral Services, 5/05
- Epogen for End-Stage Renal Disease - Changes to Billing Guidelines:
- Expansion of Provider Types for Outpatient Behavioral Health Services, Special Bulletin I, January 2005
- Expansion of Provider Types for Outpatient Behavioral Health Services, Phase II, Special Bulletin IV, May 2005
- Limitations on Medicaid Services Provided to Hospice Recipients Clarification of Policy, 08/05
- Outpatient Behavioral Health Services, 8/05
- Outpatient Specialized Therapies CCNC Pilot Project, 6/05
- Seminar Schedule for the Expansion of Provider Types for Outpatient Behavioral Health Services, 5/05
- Updates to Outpatient Specialized Therapies Prior Approval Process, 7/05
Hospitals:
- 01967 and 01996 Modifier Billing Changes, 7/05
- Clarification of Preadmission Review for Psychiatric and Substance Abuse Treatment, 3/05
- Extracorporeal Membrane Oxygenation, 7/05
- Inpatient Crossovers and DRG Payments, 3/05
- Inpatient Services with Medicare Part B Coverage Only, 3/05
- Level I Preadmission Screening Annual Resident Review (PASAAR) Screens, 11/05
- Limitations on Medicaid Services Provided to Hospice Recipients - Clarification of Policy, 8/05
- Outpatient Pathology Services, 6/05
- Preadmission Screening Annual Resident Review Seminars, 8/05
- Reimbursement Rate for Swing Beds and Lower Levels of Care Services, 4/05
- Reimbursement Rate for Vent Beds, 4/05
- Revenue Codes:
- Revenue Codes for Piedmont Participants, 8/05
- Submission of Prior Approval Requests for Transplants, 7/05
Independent Practitioners:
Institutional (UB-92/837I) Billers:
Laboratories:
- CLIA Certification Related Claim Denials
Intermediate Care Facilities for Individuals with Mental Retardation:
Local Education Agencies:
Local Management Entities:
- Clarification of First Treatment for Outpatient Specialized Therapies, 9/05
- Correct Procedure for Ordering Services and How to Determine Billable Days of Care, 3/05
- Correction to Billing Information for Dually Eligible Medicare/Medicaid Recipients Printed in the August 2005 General Bulletin, 9/05
- Direct Enrollment for Outpatient Behavioral Services, 5/05
- Expansion of Provider Types for Outpatient Behavioral Health Services, Special Bulletin I, January 2005
- Expansion of Provider Types for Outpatient Behavioral Health Services, Phase II, Special Bulletin IV, May 2005
- Level of Care Prior Approval for Intermediate Care Facilities for the Mentally Retarded (ICF/MR), 9/05
- New Contract for Utilization Review, 4/05
- Outpatient Behavioral Health Services, 8/05
- Outpatient Specialized Therapies CCNC Pilot Project, 6/05
- Seminar Schedule for the Expansion of Provider Types for Outpatient Behavioral Health Services, 5/05
- Updates to Outpatient Specialized Therapies Prior Approval Process, 7/05
Medical Doctors:
Nursing Facilities:
- Adjustments Associated with Unsupported MDS Information 2005-2006, 10/05
- Discontinuation of the 34-Day Grace Period for Prescription Drug PA for Long Term Care Facilities, 12/05
- Level I Preadmission Screening Annual Resident Review (PASAAR) Screens, 11/05
- Minimum Data Set Supportive Documentation Guidelines, 8/05
- Nursing Facility Capital Reimbursement Information Request, 6/05
- Nursing Facility Changes in Ownership, 9/05
- Preadmission Screening Annual Resident Review Seminars, 8/05
- Reimbursement Rate for Swing Beds and Lower Levels of Care Services, 4/05
- Reimbursement Rate for Vent Beds, 4/05
- Restorative Nursing Defined for Case Mix, 8/05
Nurse Midwives:
Nurse Practitioners:
- Abarelix (Plenaxis, J9999 and J0128)
- Alemtuzumab, 10 mg (Campath, J9010) - Billing Guidelines, 4/05
- Bevacizumab (Avastin) - Billing Guideline Changes, 2/05
- Natalizumab, 300 mg (Tysabri, J3490) Billing Guidelines, 3/05
- Obstetrical Ultrasounds for Multiple Fetuses, 5/05
- Paclitaxel Protein-bound Particles for Injectable Suspension, 1mg (Abraxane, J9999) - Billing Guidelines, 9/05
- Pemetrexed (Alimta, J9999) - Billing Guidelines, 1/05
- Pemetrexed (Alimta, J9999 and J9305):
OB/GYN Providers:
Optical Providers:
Optometrists:
Orthotics and Prosthetics Providers:
Osteopaths:
Outpatient Behavioral Health:
- Correct Procedure for Ordering Services and How to Determine Billable Days of Care, 3/05
- Correction to Billing Information for Dually Eligible Medicare/Medicaid Recipients Printed in the August 2005 General Bulletin, 9/05
- Direct Enrollment for Outpatient Behavioral Services, 5/05
- Enrollment of Mental Health Providers, 2/05
- Expansion of Provider Types for Outpatient Behavioral Health Services, Special Bulletin I, January 2005
- Expansion of Provider Types for Outpatient Behavioral Health Services, Phase II, Special Bulletin IV, May 2005
- Mental Health Reimbursement Rate Update, 3/05
- New Contract for Utilization Review, 4/05
- Outpatient Behavioral Health Services, 8/05
- Seminar Schedule for the Expansion of Provider Types for Outpatient Behavioral Health Services, 5/05
Personal Care Service Providers:
Pharmacists:
- Access to Over-the-Counter Medications Covered by N.C. Medicaid, 11/05
- Correction for Removal of Smoking Cessation Medications, 2/05
- Discontinuation of the 34-Day Grace Period for Prescription Drug PA for Long Term Care Facilities, 12/05
- Drug Coverage under Hospice, 7/05
- Expansion in Coverage of Zelnorm, 3/05
- Inaccurate Billing of Pharmacy Claims, 11/05
- Medicaid Recipients and Transition to Medicare Part D Prescription Drug Plans, 7/05
- Medicare Part D: Implications for North Carolina's Pharmacists and Senior Citizens:
- Medicare Part D Provider Marketing Guidelines Now Available, 10/05
- New Form Available for Oxycontin Prior Authorization, 3/05
- New Prior Authorization Procedures for OxyContin and Oxycodone Extended-Release Products, 11/05
- Over-The Counter Nicotine Replacement Therapy Medications Covered by Medicaid, 10/05
- Pharmacy Stub Audits, 7/05
- Policy and Procedures for Prescribing Synagis for RSV Season 2005-2006, 10/05
- Prescription Advantage List Update, 7/05
- Providing Compounded Prescriptions for Medicaid Recipients, 10/05
- Removal of Enbrel from the Authorization Drug List, 3/05
- Removal of Impotency Drugs from Medicaid Coverage, 7/05
- Reporting Changes of Address and Contact Information, 11/05
- Six Prescription Limit and Recipient Lock-In To One Pharmacy Each Month, 7/05
Physicians:
- 01967 and 01996 Modifier Billing Changes, 7/05
- Abarelix, 100 mg (Plenaxis, J9999) – Billing Guidelines, 1/05
- Add-on Code 61795, 7/05
- Alemtuzumab, 10 mg (Campath, J9010) - Billing Guidelines, 4/05
- Bevacizumab (Avastin), 2/05
- CLIA Certification Related Claim Denials:
- Clarification of First Treatment for Outpatient Specialized Therapies, 9/05
- Code Change for Gastric Bypass Surgery, 2/05
- Dermagraft Coverage (J7324), 4/05
- Direct Enrollment for Outpatient Behavioral Services, 5/05
- Epogen for End-Stage Renal Disease - Changes to Billing Guidelines:
- Expansion of Provider Types for Outpatient Behavioral Health Services, Special Bulletin I, January 2005
- Expansion of Provider Types for Outpatient Behavioral Health Services, Phase II, Special Bulletin IV, May 2005
- Extracorporeal Membrane Oxygenation, 7/05
- Gastric Bypass Prior Approval Documentation, 10/05
- Hyperbaric Oxygenation Therapy: Approval for Urgent Treatment, 7/05
- Into the Mouths of Babes: Oral Screening and Flouride Varnish Program, 5/05
- Natalizumab, 300 mg (Tysabri, J3490) Billing Guidelines, 3/05
- Obstetrical Ultrasounds for Multiple Fetuses, 5/05
- Outpatient Behavioral Health Services, 8/05
- Outpatient Specialized Therapies CCNC Pilot Project, 6/05
- Paclitaxel Protein-bound Particles for Injectable Suspension, 1mg (Abraxane, J9999) - Billing Guidelines, 9/05
- Pemetrexed (Alimta, J9999)–Billing Guidelines, 1/05
- Pemetrexed , 500 mg (Alimta), 02/05
- Pegaptanib, 0.3 mg (Macugen, J3490) - Billing Guidelines, 4/05
- Physicians Drug Program Pricing List Update, 10/05
- Provider Enrollment, 10/05
- Provider Enrollment, Billing, and Coverage Information, 1/05
- Revision to Rates for Occupational Therapy, Physical Therapy, Respiratory Therapy, and Audiology Services, 5/05
- Seminar Schedule for the Expansion of Provider Types for Outpatient Behavioral Health Services, 5/05
- Submission of Prior Approval Requests for Transplants, 7/05
- Updates to Outpatient Specialized Therapies Prior Approval Process, 7/05
- Ziconotide Intrathecal, 25mcg/ml and 100mcg/ml (Prialt, J3490) - Billing Guidelines, 4/05
Podiatrists:
Portable X-ray Providers:
Prescribers:
Private Duty Nursing:
Psychiatirc Hospitals:
Rural Health Clinics:
School-Based Health Centers:
Targeted Case Management for MR/DD Providers: