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Nurse Practitioners Bulletin Index

Following is a list of Medicaid General and Special Bulletin articles (2000-present) that pertain specifically to Nurse Practitioners (Physician Services).

For a complete list of articles for all providers (including articles about National Provider Identifier) refer to the Index of All Medicaid Bulletins.

• 17 Alpha Hydroxyprogesterone Caproate (17P), Injection from Bulk Powder:
  • Billing Guidelines, 4/07
  • Updated Billing Guidelines, 2/09
• Abarelix (Plenaxis, J9999 and J0128):
  • Billing Guidelines, 1/05
  • Revised Billing Guidelines, 9/05
• Abatacept, 250 mg (Orencia, J3590 and J0129):
  • Billing Guidelines, 4/06
  • Revised Biling Guidelines, 8/08
• Addition to Medical Evaluation and Management (E/M) Code for Use by Psychiatric Nurse Practitioners, 2/13
• Additions to Over-the-Counter Medications Coverage List, 1/08
• Adult Care Home Prior Approval and Admissions, 8/10
• Aflibercept Billing Guidelines
  • 2/12
  • 3/12
• After Hours, Weekend Visits, and On-Call Services, 8/01
• Agalsidase Beta, 35 mg (Fabrazyme, J3490) - Billing Guidelines, 8/03
• Aglucosidase Alfa (Lumizyme, HCPCS Code J3590):  Billing Guidelines, 1/11
• Alefacept, 7.5 mg IV; 15 mg IM (Amevive, J3490) - Billing Guidelines, 8/03
• Alemtuzumab, 10 mg (Campath, J9010) - Billing Guidelines, 4/05
• American Dental Association (ADA) Updated for the Physician Flouride Varnish (Into the Mouths of Babes) Program, 1/07
• Aminolevulinic Acid HCI for Topical Administration, 20%, Single Unit Dosage Form (Levulan Kerastick, J7308) - Billing Guidelines, 5/06
• Amphotericin B - Change in Billing Guidelines, 9/03
• Antithrombin (Recombinant) for Injection (ATryn, HCPCS Procedure Code J3590): Billing Guidelines, 9/09
• Apligraf HCPCS Code Change, 4/02
• Apoetin Alfa (Epogen/Procrit, HCPCS Code J0885) and Darbepoetin Alfa (Aranesp, HCPCS Code J0881) for Non-ESRD Use:  New Billing Guidelines, 1/10
• Arsenic Trioxide, 1mg (Trisenox, J9017) – Billing Guidelines, 1/04
• Asparaginase Erwinia Chrysanthemi (Erwinaze, HCPCS Code J9999) Billing Guidelines, 3/12
• Azacitidine, 25mg (Vidaza, HCPCS Code J9999) Billing Guidelines, 10/04
• Belatacept: Billing Guidelines,11/11
• Belimumab Injection Billing Guidelines
  • 6/11
  • 7/11
• Bendamustine (Treanda, HCPCS Procedure Codes J9999 and J9033):
  • Additional Diagnosis Codes, 4/09
  • Updated Billing Guidelines, 7/09
• Bendamustine Hydrochloride (Treanda, J9999):
  • Billing Guidelines, 6/08
  • Additional Diagnosis Codes, 1/09
• Bevacizumab (Avastin, J9035):
  • Updated Billing Guidelines, 2/05
  • Updated Billing Guidelines, 12/06
  • Correction to Billing Guidelines, 1/07
  • Updated Billing Guidelines, 4/08
  • Updated Billing Guidelines, 7/09
  • Updated Billing Guidelines, 5/10
• Bevacizumab (Avastin, J9999):
  • Billing Guidelines, 6/04
• Billing Guidelines - Revised: Pralatrexate, 6/12
• Billing Health Assessments for Refugees, 10/03
• Bortezomib, 3.5 mg (Velcade, J9999) - Billing Guidelines, 8/03
• Brentuximab Vedotin: Billing Guidelines
  • 12/11
  • 2/12
• C1 Esterase Inhibitor (Human) 10 units (Cinryze, Berinert HCPCS Code J0598):  Billing Guidelines, 2/10
• C1 Esterase Inhibitor (Human) Injectable, 10 Units (Berinert, HCPCS Code J3590): Revised Billing Guidelines, 4/10
• C1 Esterase Inhibitor (Human) Injectable, 10 Units (Cinryze, HCPCS Code J0598): Revised Billing Guidelines, 4/10
• Cabazitaxel Injection (Jevtana, HCPCS Code J9999):  Billing Guidelines, 10/10
• Calcitriol Injection, 0.1 mcg (J0636) - Billing Guidelines, 9/03
• Canakinumab Single-use Vials (180 mg) (Ilaris, HCPCS Code J3590): Billing Guidelines, 11/09
• Capsaicin 8% Patch (Qutenza, HCPCS Code J7335):  Billing Guidelines, 4/11
• Carfilzomib (Kyprolis, HCPCS code J9999): Billing Guidelines, 10/12
• Ceftaroline Fosamil Acetate (Telfaro, HCPCS Code J3490):  Billing Guidelines, 3/11
• Centruorides Immune: Billing Guidelines, 12/11
• Certolizumab Pegol (Cimzia, HCPCS Procedure Code J3590) - Billing Guidelines 8/08
• Cetuximab (Erbitux, J9055) - Update to Billing Guidelines, 8/06
• Cetuximab (Erbitux, J9999) - Billing Guidelines, 6/04
• Change in Reimbursement Rates for Injectable Immunization Administration Codes:
  • 6/07
  • 10/07
  12/07
• Changes in Drug Rebate Manufacturers:
  • 1/08
  • 3/08
  • 4/08
• Childbirth Education Policy Revision, 8/08
• Claims Denials Related to Fetal Nuchal Translucency Measurement, 10/08
• Clarification for Billing Multiple Birth, 4/11
• Clarification of the Two-Step Tuberculosis (TB) Test Process and Billing, 12/09
• Coagulation Factor VIII Complex/von Willebrand Factor (Human) (Wilate, HCPCS Code J3590): Billing Guidelines, 5/10
• Compounded Hydroxyprogesterone Caproate
  • 6/11
  • 7/11
• Correction to "Drugs Added to the Physician's Drug Program Billing Guidelines" Nelarabine (Arranon) - HCPCS Procedure Code J9261, 2/08
• CPT Codes 57452, 57454, and 57505, 4/10
• CPT Procedure Code 90761, 9/06
• Cytarabine Liposome (DepoCyt, HCPCS Procedure Code J9098) - Billing Guidelines, 8/07
• Daptomycin Injection, 1 mg (Cubicin, K0878) - Billing Guidelines, 5/06
• Darbepoetin Alfa, 5 mcg (Aranesp, J0880) – Billing Guidelines, 3/03
• Degarelix Single-use Vials for Injection (Firmagon, HCPCS Procedure Code J3490): Billing Guidelines, 9/09
• Denials for New Patient Eye Exams, 11/08
• Denosumab Injection (Prolia, HCPCS Code J3590):  Billing Guidelines, 9/10
• Denosumab (Xgeva, HCPCS Code J3590):  Billing Guidelines, 3/11
• Dexamethasone Implant, Intravitreal, 0.1 mg, 8/11
• Dexamethasone Implant, Intraviteral (Ozurdex, HCPCS Code J3490): Billing Guidelines, 2/10
• Dexrazoxane (Totect, HCPCS Procedure Code J3490) - Billing Guidelines, 4/08
• Doripenem (Doribax, HCPCS Procedure Code J3490) - Billing Guidelines, 4/08
• Drugs Added to the Physicians Drug Program Billing Guidelines, 1/08
• Durable Medical Equipment Prescriptions and Certificate of Medical Necessity and Prior Approval Forms, 3/03
• Ecallantide Injectable (Kalbitor, HCPCS Code J3490): Billing Guidelines, 5/10
• Eculizumab, 300mg/30ml single-use vial (Soliris, J3590) Billing Guidelines, 6/07
• Epoetin Alfa (Epogen/Procrit, HCPCS Code J0885) and Darbepoetin Alfa (Aranesp, HCPCS Code J0881): New Billing Guidelines, 12/10
• Eribulin Mesylate (Halaven, HCPCS Code J9999):  Billing Guidelines, 3/11
• Etonogesterel, 68-mg Implant (Implanon, HCPCS Procedure Code J3490) Billing Guidelines, 11/06
• Factor VIIa (Coagulation Factor, Recombinant) per 1.2 mg (Novoseven, Q0187) – Billing Guidelines, 2/03
• Factor VIII (Xyntha, HCPCS Procedure Code Q2023): Billing Guidelines, 7/09
• Ferrlecit (Sodium Ferric Gluconate Complex in Sucrose, HCPCS Code J2916, 12.5 mg Injection) - Billing Guidelines, 10/03
• Ferrlecit (Sodium Gluconate Complex, HCPCS Code J2915, 625 mg.) Coverage Criteria, 1/02
• 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
• Fondaparinux Sodium Injectable 0.5 mg (Arixtra, HCPCS Code J1652):  Billing Guidelines, 2/10
• Fosaprepitant Dimeglumine (Emend, HCPCS Procedure Code J3490) - Billing Guidelines, 4/08
• Fulvestrant, 250mg/5ml (Faslodex, J9999) – Billing Guidelines, 2/03
• Gemtuzumab Ozogamicin, 5mg (Mylotarg, J9300) Billing Guidelines, 10/04
• Golimumab (50 mg per 0.5 ml) for Injection (Simponi, HCPCS Procedure Code J3590): Billing Guidelines:
  • 7/09
  • 12/09
• Hemin, 1mg (Panhematin, HCPCS Procedure Code 1640) - Billing Guidelines, 10/08
• Histrelin Acetate (Supprelin LA, J3490) Billing Guidelines, 9/07
• Human Thrombin Topical Protein (Evithrom, HCPCS Procedure Code J3590) - Billing Guidelines, 4/08
• Human Thrombin Topical Protein, Preservative-Free (Recothrom, HCPCS Procedure Code J3590) - Billing Guidelines, 4/08
• Hydroxocobalamin, 5 gram kit (Cyanokit, J3490) Billing Guidelines, 6/07
• Hydroxyprogesterone Caproate (Makena, HCPCS Code J3490):  Billing Guidelines, 4/11
• Ibandronate Sodium 3-mg/3-ml injection (Boniva, HCPCS Procedure Code J3490) Billing Guidlines, 12/06
• Idursulfase/Elaprase (HCPCS Procedure Code J3490) - Billing Guidelines, 3/07
• Immune Globulin (IgIV, Human, for Intravenous Use, CPT 90283) Coverage Clarification, 9/01
• Immune Globulin Intravenous Injection (J1563, 1 gm and J1564, 10 mg) - Billing Guidelines, 9/03
• Immune Globulin, Non-lyophilized Intravenous (Privigen, J3590) - Billing Guidelines, 4/08
• Immune Globulin Subcutaneous (Human) Injectable (Hizentra, HCPCS Code J3590): Billing Guidelines, 6/10
• Implantable Contraceptive Capsules, 5/00
• Infliximab (Remicase, HCPCS Code J1745) and Rituximab (Rituxan, HCPCS Code J9310): New Billing Guidelines, 11/09
• Injectable Drug Coverage through the Pharmacy and Physician’s Drug Programs, 4/03
• Injectable Drugs:  Update to Billing Guidelines, 10/10
• Injection, Ertapenem Sodium, 500 mg (Invanz, HCPCS Procedure Code J1335) Billing Guidelines, 11/06
• Injection, Factor X111 Concentrate, 9/11
• Injection, Icatibant Acetate: Billing Guidelines, 12/11
• Injection, Von Willebrand Factor Complex (Human), Wilate, 8/11
• Interferon Beta-1a (Avonex, HCPCS Procedure Code Q3025): Billing Guidelines, 8/09
• Interferon Beta-1b Injectable (Extavia, HCPCS Code J1830): Billing Guidelines, 2/10
• Intrauterine Devices Billable on the CMS-1500 Claim Form - Reimbursement Rates, 6/04
• Ixabepilone Kit for Injection (Ixempra) - Billing Guidelines, 8/08
• Ixabepilone Kit for Injection (Ixempra, HCPCS Procedure Code J3490) - Billing Guidelines, 4/08
• Lacosamide Single-Use Vials for Injection (Vimpat, HCPCS Procedure Code J3490): Billing Guidelines, 7/09
• Lanreotide Injection (Somatuline Depot, HCPCS Procedure Code J3490) - Billing Guidelines, 4/08
• Laronidase, 2.9 mg/5 ml (Aldurazyme, J3490) - Billing Guidelines, 8/03
• Leuprolide Acetate Implant, 65mg (Viadur, J9219) – Billing Guidelines, 2/03
• Leuprolide Acetate Injectable (HCPCS Procedures Codes): Change in Billing Guidelines, 10/09
• Levetiracetam, 500-mg/5ml Injection (Keppra, HCPCS Procedure Code J3490) Billing Guidelines, 11/06
• Lidocaine for Topical Anesthesia and Saline/Water Codes: Billing Guidelines, 12/09
• Linezolid, 200mg (Zyvox, J2020) Billing Guidelines, 7/07
• Lymphocyte Immune Globulin, Antithymocyte Globulin, Equine, Parenteral, 250 mg (Atgam, J7504) Billing Guidelines, 4/06
• Makena Billing Guidelines Revised for the Physician's Drug Program , 7/11
• Medroxyprogesterone Acetate/Estradiol Cypionate, 5 mg/25 mg (Lunelle, HCPCS Code J1056) – Billing Guidelines, 4/03
• Methyl Aminolevulinate (MAL) for Topical Administration, 16.8%, 1 Gram (Metvixia, HCPCS Code J7309):  Billing Guidelines, 4/11
• Mirena (Levonorgestrel-Releasing Intrauterine System, Code J7302) Coverage Criteria, 3/02
• Modifier YR – Routine Foot Care, 11/02
• Natalizumab (Tysabri, HCPCS Procedure Code J2323) - Update to Billing Guidelines, 5/08
• Natalizumab, 300 mg (Tysabri, J3490) Billing Guidelines, 3/05
• National Drug Codes:
  • National Drug Code (NDC) Implementation, Special Bulletin, October 2007 - Revised 5/20/08
  • National Drug Code Implementation December 28, 2007, 12/07
• Norplant Insertion Kit, 10/00
• Nurse Practitioners Enrollment and Billing Instruction, 9/11
• Obstetrical Ultrasounds for Multiple Fetuses, 5/05
• Octreotide Acetate, 1 mg (Sandostatin LAR Depot, J2352) – Clarification to Billing Guidelines, 4/03
• Ofatumumab Injectable (Arzerra, HCPCS Code J9999):  Billing Guidelines, 2/10
• Olanzapine Injectable (Zyprexa Relprevv, HCPCS Code J3490, and Zyprexa, HCPCS Code S0166): Billing Guidelines, 5/10
• Omalizumab (Xolair, J3490) – Billing Guidelines, 1/04
• Omalizumab, 5 mg (Xolair, HCPCS Code J2357):  Change in Coverage,
  • 4/11
  • 5/11
• Oxaliplatin, 7/11
• Oxaliplatin (Eloxatin, HCPCS Procedure Code J9263) - Additional Diagnosis Codes:
  • 10/08
  • 1/09
  • 5/09
• Oxaliplatin, 50 mg (Eloxatin, J9999) - Billing Guidelines, 9/03
• Paclitaxel Protein-bound Particles for Injectable Suspension, 1mg (Abraxane, J9999) - Billing Guidelines, 9/05
• Paliperidone Palmitate Exended Release, 1 mg (Invega Sustenna,HCPCS Code J2426):  Billing Guidelines, 4/11
• Palonosetron 0.25 mg (Aloxi, J3490) – Billing Guidelines, 1/04
• Pantitumumab, 20 mg/ml Injectable (Vectibix, J999) Billing Guidelines, 1/07
• Pegfilgrastim, 6mg (Neulasta, S0135) – Billing Guidelines, 2/03
• Peginterferon Alfa-2B Injection Billilng Guidelines, 7/11
• Pegloticase (Krystexxa, HCPCS Code J3590):  Billing Guidelines, 3/11
• Pegylated Interferon Alfa-2b, 10 mcg (PEG-Intron, HCPCS Procedure Code J3590) Billing Guidelines, 11/06
• Peinterferon Alfa - 2a, 180 mcg/ml (Pegasys, J3490 and S0145) - Billing Guidelines, 5/06
• Pemetrexed (Alimta, J9999 and J9305):
  • Billing Guidelines, 6/04
  • Billing Guidelines, 1/05
  • Revised Billing Guidelines, 2/05
• Physician Assistant and Nurse Practitioner Enrollment, 11/11
• Plerixafor, 1.2 ml Single-use Vials for Injection (Mozobil, HCPCS Procedure Code J3490) Billing Guidelines, 3/09
• Plerixafor Injection (Mozobil, HCPCS Procedure Code J3490) - Correction to Reimbursement Rate, 4/09
• Pralatrexate Injectable (Folotyn, HCPCS Code J9999):  Billing Guidelines, 2/10
• Pregnancy Medical Home Project Seminars:
  • 1/11
  • 2/11
  • 3/11
• Prescribing and Documenting Brand Medically Necessary Drugs, 6/12
• Progestacert IUD, W5142 Now End-dated, 4/03
• Protein C Concentrate (human) (Ceprotin, J3590) Billing Guidelines, 9/07
• Purchasing Drugs for Administration in a Provider's Office, 9/03
• Ranibizumab (Lucentis, HCPCS Code J2778):  Update to Billing Guidelines, 10/10, 11/12
• Rasburicase, 0.5 mg (Elitek, HCPCS Procedure Code J2783), 3/09
• Rate Increase for Physician Fluoride Varnish Services, 9/08
• Reducing Crossover Denials, 1/01
• Regadenson (Lexiscan) Billing Guidelines, 6/09
• Requesting an Exception to the Legislative Visit Limit, 9/09
• Rilonacept (Arcalyst, HCPCS Code J2793):  Billing Guidelines, 2/10
• Risperidone (Risperdal Consta, J3490) – Billing Guidelines, 01/04
• Romidepsin, 1 mg (Istodax, HCPCS Code J9315):  Billing Guidelines, 4/11
• Romiplostim (Nplate, HCPCS Procedure Code J3490) - Billing Guidelines, 12/08
• Sildenafil Injectable (Revation, HCPCS Code J3490): Billing Guidelines, 5/10
• Sodium Fluoride F-18 (HCPCS Procedure Code A9580) - Billing Guidelines, 6/09
• SPECIAL BULLETIN - Addition of Medical Evaluation and Management (E/M) Codes for Use by Psychiatric Nurse Practitioners, 2/13
• Telavancin Injectable (Vibativ, HCPCS Code J3490):  Billing Guidelines, 2/10
• Temozolomide Single-use Vials for Injection (Temodar, HCPCS Procedure Code J9999): Billing Guidelines, 9/09
• Temsirolimus (Torisel, J3490) Billing Guidelines, 9/07
• Testosterone Pellets (Testopel, HCPCS Procedure Code S0189) - Billing Guidelines, 4/09
• Tigecycline, 1 mg (Tygacil, HCPCS Code J3243):  Billing Guidelines, 4/11
• Tocilizumab Injectable (Actemra, HCPCS Code J3590): Billing Guidelines, 5/10
• Triptorelin Pamoate (Trelstar Depot and Trelstar LA, J3315) Billing Guidelines, 8/06
• Ustekinumab Injectable (Stelara, HCPCS Code J3590): Billing Guidelines, 2/10
• Varicella-Zoster Immune Globulin, Human, for Intramuscular Use (CPT 90396), Billing Guidelines, 8/02
• Velaglucerase Alfa Injectable (VPRIV, HCPCS Code J3590): Billing Guidelines, 6/10
• 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
• Ziv-aflibercept (Zaltrap), HCPCS code J9999): Billing Guidelines, 11/12
• Zoledronic Acid, 1mg (Reclast, Q4095) Billing Guidelines, 7/07
• Zoledronic Acid (Reclast, HCPCS Code J3488):  Update to Billing Guidelines, 10/10