Other Medical Professionals

Other Medical Professionals

After Hour Add On Service Codes

Effective for dates of services on or after April 1, 2013, the South Carolina Department of Health and Human Services (SCDHHS) will cover CPT codes:

Changed/Added Procedure Codes

 

 

The Centers for Medicare and Medicaid Services (CMS) revises the nomenclature within the HCPCS/CPT each quarter.  When a HCPCS/CPT code is deleted, the SC Medicaid program will discontinue coverage of the deleted code and new procedure codes for behavioral health services may be added.  The SC Medicaid program will not accept billing of discontinued codes for dates of service on the date on which the code is discontinued.  

Barbiturate and Benzodiazepine Coverage Changes for Dual Eligibles under Medicare Part D Plans

 

Effective January 1, 2013, the South Carolina Department of Health and Human Services (SCDHHS) will exclude coverage for barbiturates “used in the treatment of epilepsy, cancer, or a chronic mental health disorder” and benzodiazepines for dual eligible individuals (Medicare/Medicaid).  This exclusion of coverage applies only to dual eligible individuals.

ADDITIONAL SERVICES PERFORMED BY KEPRO

 

Effective with dates of service on or after October 1, 2012, the South Carolina Department of Health and Human Services (SCDHHS) will require prior authorization (PA) for the following services and medical record pre-payment review from our Quality Improvement Organization (QIO), KePRO.

Long Acting Birth Control Device provided in a Hospital Setting

 

Effective for dates of services on or after March 1, 2012, the South Carolina Department of Health and Human Services (SCDHHS) is updating its policy to include reimbursement for long acting birth control devices provided in a hospital setting.  The coverage of this service will be considered an add-on benefit and will not be included in the Diagnostic Related Group (DRG) reimbursement system.  The following codes will now be covered separately:

 

Tobacco Cessation for Pregnant Women

Effective with dates of service on or after February 1, 2012, the South Carolina Department of Health and Human Services (SCDHHS) will cover Tobacco Cessation treatment for all pregnant women in accordance with Section 4107 of the Affordable Care Act, which amended Section 1905 (bb)(2) of the Social Security Act. For the complete policy and billing instructions, please review the Physician, Laboratories and Other Medical Professionals manual located on the SCDHHS website at www.scdhhs.gov.

Spacers for Metered Dose Inhalers

 

 

I.              Spacers for Metered Dose Inhalers

Pages

Subscribe to RSS - Other Medical Professionals
Report Fraud