North Carolina Medicaid billing update

Claims for inpatient hospital sterilization

According to the NC Medicaid Clinical Coverage Policy 1E-3, when health care professionals submit a claim for sterilization during an inpatient stay where the sterilization is not covered, they should:

Submit the claim placing non-covered charges (such as sterilization) in the non-covered column
Not include a sterilization diagnosis or an ICD-10 procedure code for sterilization on the claim

For historical claims where providers included a sterilization diagnosis or an ICD-10 procedure code when billing non-covered sterilization for inpatient hospital claims, they should resubmit the claim without the sterilization diagnosis or ICD-10 procedure code.