Below is an excerpt from Special Medicaid Bulletin June 2013:
MISCELLANEOUS CODE T1999
· A maximum of $250 per beneficiary per state fiscal year may be billed without prior approval required.
· Any amount over $250 per beneficiary per state fiscal year, whether for a single item or a cumulative total, requires prior approval.
· A maximum of $1,500 per beneficiary per state fiscal year may be billed.
NOTE: For any service or supply which requires prior approval, providers must complete a General Request for Prior Approval form 372-118 (located at www.ncdhhs.gov/dma/forms/prior.pdf) and return it to DMA.
You can view the full Special Bulletin at: https://ncdma.s3.amazonaws.com/s3fs-public/documents/files/0713bulletin.pdf
NOTE: If you would like to view all the supplies, within your agency, that has been assigned the HCPCS T1999, please do the following:
a. Go to Barnestorm Office
b. Select Reports tab
c. Select Supplies
d. Select 52.08 Supplies with HCPCS Codes. You can leave ZZ in there to skip inactive supplies or remove it. Enter T1999 in the HCPCS field.
e. Hit Print Report
NOTE: If you would like to track what has been billed for HCPCS code T1999, per patient, you can utilize report option 02.13 Supplies Used Detail.
a. Go to Reports>Billing>02.13 Supplies Used Detail
b. At HCPCS Code, enter T1999
c. Fill in the other fields as appropriate
d. Print the report