Billing/Claims/Reimbursement

Timely Filing Extension Due to Change Healthcare Cyberattack

Due to the recent cyberattack on Change Healthcare, ND Medicaid will extend timely filing requirements for claims with dates of service on or after 09/21/2023. Claims must be submitted by either 06/25/2024 or the regular timely filing deadline, whichever is later.

If you are unable to submit claims electronically to the department, you may send them on paper or submit your claims via the MMIS Web Portal.

Codes Requiring Service Authorization spreadsheet has been updated

The following drugs have been added and will require service authorization for dates of service on or after April 1, 2024.

UPDATED ICD-10-CM Coding Guidance - Administering Abrysvo™ (CPT 90678) to Pregnant Individuals

CDC recommends one dose of Pfizer’s bivalent RSVpreF vaccine (Abrysvo) during RSV season for people who are 32 through 36 weeks pregnant. For claims to correctly adjudicate for this population of ND Medicaid members, an ICD-10-CM code specific to the third trimester of pregnancy AND an ICD-10-CM code from the Z3A.32 - Z3A.36 range must be present on the claim and pointed to the specific line that 90678 is billed on.

Attention Providers: Cybersecurity Isse Impact on ND Medicaid

ND Medicaid is aware of a cyber security issue that occurred on February 21, 2024, that impacts providers who use Change Healthcare as their clearinghouse, trading partner, or pharmacy switch vendor. ND Medicaid systems and claims processing are not affected by the cyber security issue. Connections with Change Healthcare will be re-established when Change Healthcare is no longer experiencing cyber security issues.