From NC Medicaid:

Some private and commercial insurers already require these codes, so providers should check with their billing team to review relevant protocol. These F codes are required by NC Medicaid’s clinical policy and apply to all delivery claims (not just those that are globally billed).

NC Medicaid urges providers to begin using the new codes as soon as possible. After July 1, 2025, Medicaid claims for delivery will deny if 0500F is not in the patient's history. This change will apply to both NC Medicaid Managed Care and NC Medicaid Direct claims.

Details and Source: New F Codes: Capturing Prenatal and Postpartum Care Services

Blue Cross and Blue Shield of North Carolina’s Risk Adjustment Coding Provider Education and Engagement Team is offering Microsoft LIVE meetings in 2023.

Recently, the Center for Medicare and Medicaid Services (CMS) made some changes and additions to coding for care management services.

2021 brings some exciting new changes to the guidelines for evaluation and management services. To reduce the administrative burden, the Evaluation & Management (E/M) documentation guidelines have been updated to provide more flexibility and allow providers to spend more time focusing on patient care and less on documentation and coding. Providers now have new options for documenting and reporting E/M visits.  

Are you planning on administering COVID-19 Vaccines in your office? 

NCDHHS has shared the Medicaid and NC Health Choice billing guidance for both the Pfizer-BioNTech and Moderna vaccines in two Special Bulletins (#147 and #148).  Please see some of the billing highlights and links to the bulletins below. 

What’s new and different in 2021? 

The Centers for Medicare & Medicaid Services (CMS) issued a final rule on December 1st, 2020 that includes policy updates for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective on or after January 1, 2021.