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WASHINGTON (WUSA) -- Do you want to read a recap of the Spurs 118-92 victory over the Washington Wizards? Of course you don't. You have Ted Leonsis' blog for those purposes.
So please, go ahead and humor yourself with my take on the events of Monday, November 26th at the Verizon Center.
5:37: Wizards head coach Randy Wittman jokes about how he wishes the Spurs got caught up in a snowstorm while playing the Toronto Raptors in Canada. It sounded to me like he was only half kidding too. When somebody wishes a snowstorm to happen, that's when you know they absolutely hate going to work.
6:20: TNT reporter David Aldridge works the media room crowd like he's an incumbent politician. People glow over his thoughts on RGIII, Maryland to the Big 10, and the New York Knicks. Believe it or not, Aldridge didn't field any questions on the Wizards.
7:01: Nats GM Mike Rizzo is in attendance. Wait, I know how to get fans in the seats! Raffle away Nats season tickets. Not just that though. Throw out Natitude t-shirts, Curly W hats and even have ceremonial 'first shots' from Nats players. Once pitchers and catchers report in February, media coverage for the Wizards will shrink by 33 percent.
7:11: The fact that the Wizards still make their fans stand up until the first basket is made is cruel and unusual punishment, something the constitution legally protects citizens from. This is a team dead last in field goal percentage, three-point percentage and points per game. Hey Ted, you shouldn't demand any type of action from your dwindling fan base. Be happy TiVo exists or the 10,000 people who showed up on Monday would be at home watching X-Factor.
7:24: What if Gary Neal turns out to be better than Bradley Beal. #ThoughtsWizardsFansActuallyHaveToPonder.
7:26: When does Trevor Ariza's buyout happen? He plays like he permanently has strep throat.
7:35: I've got a brilliant idea. Instead of showing the Wizards on the big screen, it should be a running loop showing the best "Kiss Cam" moments. Would anyone honestly vote no against this?
7:44: One thing the Wizards haven't changed throughout the years: they have the most abominable internet capabilities of any sporting venue I've ever been too. Isn't this something VERIZON could help correct? I guess good internet connectivity is just as hard as putting together a half-decent NBA roster.
8:02: The Spurs make more wide open shots than Vincent Chase from Entourage.
8:19: I go to the media room for halftime, come back out to my seat and it's at least 8 degrees colder in the building. Ted, are you really cutting costs midway through the game?
8:34: There are fifth grade girls with more coordination than Jan Vesely. Hell, he falls on the floor more than half of the Capitals on ice. Since the team is on the verge of starting 0-12, I think fans are due an apology from team president Ernie Grunfeld. "I'm sorry," may alleviate some of the pain.
8:49: The dance cam is struggling to find enthusiastic fans -- even toddlers in the building are grasping. You just can't fake energy in this type of atmosphere. Not even Michael Jackson would bust a move when his home team was down 102-74 early in the fourth quarter. Get used to this Verizon Center. It's not even December.
8:55: Cue the fire drill at the Verizon Center. Fans stream towards the exits at the 5:51 mark in the fourth quarter.
9:09: Is anyone else starting to think John Wall is healthy? I'm starting to lean that way. His knee injury had an eight week timetable...well, it's been eight weeks and he hasn't even PRACTICED. I don't blame Wall for milking this injury. What is the rush to get back? His agent is probably concocting his client's exit strategy from D.C. as we speak.
9:22: The Wizards (0-12) have completed just 14.6 percent of their NBA season, yet it's already over. Nobody legitimately enjoys coming to work here anymore. Most hair products do a better job of gelling than the Wizards roster. The beat reporters obviously are having trouble putting together fascinating stories with the lack of any activity. The entire coaching staff is already anticipating when they'll be fired. Life at the Verizon Center is at an all-time low, and there are no signs pointing to when the misery will end.


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Though the path to discovering your personal style is usually a solitary journey, every once in awhile we find ourselves stuck in front of the mirror, unsure of where to turn. Luckily, we can always gain a little guidance and inspiration from our Myspace Muses, as they've got sartorial savoir-faire in spades. Hailing from all corners of the globe, we like to think of these fashion plates as our compatriots in the ongoing search for superlative style. Not content to merely follow the current fashion, these girls stand out by creating their own trends, or, impressively, making trends their own. Whether it's the way they boldly wear the season's most challenging silhouettes, assert themselves in studded heels, or revamp girly skirts with boyish basics, these ladies motivate and encourage us with their personal panache. So try a little help from these fashion-minded friends when wondering what to wearÂ--we promise they'll leave you with plenty of trendsetting tips to help you on your way!
Feminine full skirts and boyish basics look modern together.
Our first muse, Lisa, 24, from South Africa, has taken a retro feminine pieceÂ--the full, floral skirtÂ--and made it relevant once again by styling it with menswear-inspired pieces, including a simple t-shirt and boyfriend blazer. This modern mix causes us to swoon with spring fever and makes us want to create a boy-meets-girl getup too! Fortunately, there's no need for outfit envy as this pleasantly surprising combo is easy to pull off on your own. Just match your favorite oversized blazer with a festively patterned skirt; we like the bold print of See by Chloe's
Floral Skirt ($475), though you can achieve a similar effect with the DMBM Floral Print Cotton Skirt ($32) as well.
An all-black outfit keeps the focus on a fashion-forward silhouette.
Playing with color is always a bold choice, but sometimes the opposite is equally true. As demonstrated by Anna-Marie, 26, from Finland, restraint can be completely chic. Take her harem pants, for example: by keeping her outfit all black, she turns the spotlight onto their interesting cut and shape. If you're intrigued by these cool contours and want to try a few similarly designed pieces, start with Vanessa Bruno's Asymmetric Frill Blouse ($460). We think the subtle frill will add a feminine touch to any outfit. Another way to summon-up style is with Maje's outstanding Harem Pants ($445). The slouchy cut is definitely directional, while the supple suede is an unexpected and luxurious upgrade. However (because today we're full of options for you!), if you prefer to test out this trend without total commitment, you can always turn to your favorite leggings-and-tee purveyorÂ--American Apparel. The unconventional brand is currently stocking their own version of Harem Pants ($40), which is an excellent buy with amplified style at an understated price.
Bold belts and a long cardigan adds interest to a simple spring skirt.
Trying to top the fashion charts in transitional wear is always a difficult endeavor. You can conquer this challenge by taking a cue from Silvia, 33, from Spain, and the way she eases into a new season with a thoughtfully assembled look. Using a charming chambray skirt as the base of her outfit, Silvia upped the ante by adding a statement belt and throwing on a long, cozy cardigan. Create your own version of Silvia's style by picking up a Mink Pink Dandelion Skirt ($63), adding a darling waist-cincher, like Kimchi Blue's Floral Stretch Belt ($34), and finishing the whole thing off with Free People's Cotton Hooded Cardigan ($138). The result of all this lightweight layering à la Silvia is a pretty yet practical ensembleÂ--who could resist?
Assertive high heels toughen up a soft scarf and slouchy tee.
Moving on to our next style guru, we have Tamara, 20, a spirited Australian who knows how to strike a poseÂ--and then some! Opting for studded, spiky heels, like the Guess Vashti Sandals ($125), to dress up the casualness of a drapey tee, she teaches us a thing or two about balance. She further demonstrates a sense of sartorial harmony by selecting a feminine, floral scarf, which gives her whole ensemble a lovely polished look. Should you desire a hint of wardrobe-Zen yourself, pair Elizabeth & James' Deconstructed T-Shirt ($90) with Urban Outfitters' Japanese-inspired Hersey Shibori Scarf ($34) for an equally inspired look.
A structured safari jacket looks chic with draped, cuffed trousers.
Palm trees and porches and pools...oh my! As you can see from Amy's photo, it's a jungle out there in Encino, California. Luckily, this Myspace Muse, 22, has a knack for navigating the treacherous terrainÂ--of her closet. Learn how to rough it yourself (ha!) in Free People's Sue's Rugged Cotton Duster ($168), or for a more incognito safari-style adventure, try Forever 21's Aleia Trench Coat ($25). Once you've settled on a khaki top or trench, the next item on the itinerary is to juxtapose that structured piece with a softer, slouchy pair of tapered trousers. We recommend Free People's Pocket Harem Pant ($98); just tuck in a bright blouse and finish with your outgoing outerwear of choice.
Skinny jeans, a striped top, and a moto jacket are all current classics.
To finish off this month's Myspace Muses, we chose Lena, 20, a fashionable Fin who shows us an impeccable outfit comprised of modern must-haves. Although her ensemble is not groundbreaking per se, we commend her for a flawless mix of prime pieces, all perfectly pulled together to a (striped!) tee. The best part about masterminding this mix is you most likely already have these items in your closet! If not, replicate Lena's look with a simple skinny jean (we like the Brooke Skinny Zipper Jeans ($205) by Anlo), a cool black and white shirt (Topshop's Cape Stripe Tunic ($44) fits the bill), and a motorcycle jacket for a bit of sexy edge. Since this jacket can toughen up any outfit from spring trousers to a summer dress, you may consider investing in Rag and Bone's
Motorcycle Jacket ($560). The Cropped Leather Biker ($153) version from ASOS is also a good choice and won't break the bank!Â--Liza Kaplan
If you want even more inspiration, check out MySpace Fashion for style tidbits, insider info, and fantastic stories galore! As always, our search for new muses is ongoing, so don't hesitate to recommend yourself or a friend. Just email us (email@example.com) your name, age, email address, and the best full-length shots* that convey your personal style!
*Photos must be full-length and will not be considered if blurry or poorly lit. Thank you!

subset: commoncrawl


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In This Issue
| All Providers:
Health Departments:
Home Health Providers:
The Division of Medical Assistance (DMA) and EDS will be closed on Monday, January 1, 2001 in observance of New Years Day, and on Monday, January 15, 2001 in observance of Martin Luther Kings Birthday.
EDS, 1-800-688-6696 or 919-851-8888
Because fluoride varnishes have been proven effective in the prevention of
early childhood caries, especially for children under thirty-six (36) months
of age, the Division of Medical Assistance is adding coverage for a new oral
screening preventive package. This package is recommended for all Medicaid eligible
recipients from the time teeth erupt to thirty-six (36) months of age. Prior
approval is not required for these procedures and services must not be billed
until provider training has been obtained. (Up to six (6) applications allowed
over a 3-year period.)
|Procedure Code
|Initial Oral Screening
* includes early caries screening and detection of other notable findings in the oral cavity
* includes prevention and dietary counseling
* includes prescribing a fluoride supplement, if indicated
* includes application of fluoride varnish
* Medicaid can only allow reimbursement for this oral screening when teeth are present and fluoride varnish is applied to the teeth
* limited to recipients under 3 years old
* allowed once per provider for each recipient
* periodic oral screening is recommended four (4) to six (6) months after the initial oral screening
* exempt from third party liability
Reimbursement: $43.00 for the entire mouth
|Procedure Code
|Periodic Oral Screening
* includes early caries screening and detection of other notable findings in the oral cavity
* includes prevention and dietary counseling
* includes application of fluoride varnish
* Medicaid can only allow reimbursement for this oral screening when teeth are present and fluoride varnish is applied to the teeth
* limited to recipients under 3 years old
* periodic oral screening is recommended four (4) to six (6) months after the initial oral screening
* periodic oral screening and fluoride varnish application are recommended two (2) times per year at four (4) to six (6) month intervals for the same or different provider
* exempt from third party liability
Reimbursement: $35.00 for the entire mouth
Initial Oral Screening must include:
Providers of Service
Licensed physicians or the designated physician extender (PA, Nurse Practitioner, RN, or LPN)
Place of Service
Physicians office, health department clinics, Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC), and other appropriate clinic settings.
Claims Filing Process
Prior approval is not required for these services. These services are to be billed on the HCFA-1500 claim form or electronically through ECS after provider training is obtained. Billing instructions will be given at all training sessions.
Provider Training and Continuing Education
It is required as a condition of participation, that the physician or physician extender attend a Medicaid recognized continuing education (CE) course of 1 to 2 hours to prepare for the delivery of these services. Only providers who have been trained should render these services and submit claims for payment. The N.C. Academy of Family Physicians and the N.C. Pediatric Society will implement the provider training. The UNC School of Dentistry and Public Health and the Dental Health Section are involved in designing the course and preparing brochures and other educational materials for distribution to the Medicaid recipients family when services are rendered. Watch upcoming Medicaid Provider Bulletins and Academy and Society mailings for course dates and locations.
Product information
Duraphat is a fluoride varnish accepted by the American Dental Association. According to experts at the UNC School of Dentistry, fluoride varnish is practical, safe, and easy to apply to the teeth of infants and very young children and is extremely useful in the prevention of early childhood caries. The varnish comes in a tube and is applied in a thin layer to all surfaces of CLEAN, DRY teeth using a disposable brush. Teeth should be cleaned for this age group with a soft wipe or a toothbrush prior to fluoride varnish application. Additional information will be available through the continuing education course materials and aids.
Betty King-Sutton, D.M.D., Dental Program
The North Carolina General Assembly has enacted Senate Bill 1234 to ensure that consenting residents and employees of nursing facilities and adult care homes are immunized against influenza each year. The legislation relative to influenza becomes effective September 1, 2001, and vaccination is required unless it is medically contraindicated, would violate the residents or employees religious beliefs, or is refused after they are fully informed of the health risks of not being immunized. Although the legislation is not effective until September, facilities are encouraged to offer this very important health benefit now.
The legislation also requires that consenting residents receive the pneumonia vaccine as needed. This was effective September 2000. Recommendations from the Centers for Disease Controls (CDC) Advisory Committee on Immunization Practices for persons 65 and older state, "All persons in this category should receive the pneumococcal vaccine, including previously unvaccinated persons and persons who have not received vaccine within five years (and were less than 65 years of age at the time of vaccination). All persons who have unknown vaccination status should receive one dose of vaccine."
A November 22, 2000 Health Care Financing Administration (HCFA) press release recommends that both of these vaccinations be made a part of residents annual drug regimen review to improve immunization rates. Between 20,000 and 40,000 deaths are attributed to flu and pneumonia in the United States each year. More than 90 percent of the deaths occur in people age 65 and over. Among elderly nursing home residents, influenza vaccine can be 50 to 60 percent effective in preventing hospitalization for pneumonia, and 80 percent effective in preventing death. Pneumococcal vaccination is 60 to 70 percent effective in preventing invasive (bacterial) pneumococcal infection.
In view of the shortage of flu vaccine, the CDC has issued a notice urging "both health care providers and the public to be patient, but persistent in their efforts to get flu vaccine." The CDC has "developed an Influenza Vaccine Availability website that provides information about the availability of influenza vaccine from manufacturers and wholesale distributors and will list state health departments that may have information about vaccine availability among local providers. The list will be updated weekly." The website can be accessed at http://www.cdc.gov/nip/flu/. The National Pneumonia website contains documents developed for this particular flu season by HCFA and CDC.
Facilities requiring assistance from local health departments to provide immunizations are advised to contact those health departments early in 2001 to allow adequate planning time as well as time to order vaccine
Ann H. Kimbrell, R.N.
All Providers
2000 CPT Update, 1/00
Accessing Hospice Participation Information on Automated Voice Response, 5/00
Additional Medicaid Fair Handbooks Still Available, 3/00
Basic Medicaid Seminar Schedule, 2/00; 3/00
Change in the Carolina ACCESS Emergency Room Reimbursement Policy, 9/00
Changes to CPT 2000 Coverage, 3/00
Corrected 1099 Requests-Action Required by March 15, 2000, 1/00; 2/00
Correction to the August 2000 Bulletin Article "Modifier 25 and Minor Procedures", 10/00
Coverage of 7-Valent Pneumococcal Polysacchride-Protein Conjugate Vaccine (PCV7), 12/00
Coverage of Atrial Septectomy or Septostomy, 11/00
Denied Managed Care Claims, 8/00
Directions to the DME and Basic Medicaid Seminars, 3/00
Directions to the PASARR Seminars, 3/00
Electronic Funds Transfer (EFT) Form, 8/00; 11/00
Electronic Funds Transfer (EFT), 11/00
Endoscopy CPT Base Codes and Their Related Procedures, 7/00; 8/00
Facsimilies and Electronic Signatures, 11/00
Fee Schedules, Reimbursement Plans and Medicaid Bulletin Subscriptions, 5/00
Forms Available on Website, 4/00
Forms, 2/00; 8/00
Health Insurance Information Referral Form, 8/00
Holiday Observance, 1/00; 3/00; 4/00; 5/00; 6/00; 7/00; 9/00; 11/00; 12/00
Implantable Contraceptive Capsules, 5/00
Index of all 1999 General Bulletin Articles and Special Bulletins, 2/00
Index of all 2000 General Bulletin Articles and Special Bulletins, 8/00
Letter and Report Summary to All Providers from Secretary H. David Bruton, 12/00
Mail Service Center Addresses, 11/00; 12/00
Medicaid Adjustment Form, 2/00; 9/00; 10/00; 11/00; 12/00
Medicaid Bulletins on DMA Website, 6/00
Medicaid Credit Balance Report Form, 9/00
Medicaid Credit Balance Reporting, 9/00
Medicaid Managed Care HMO Risk Contract Update, 7/00
Medicaid Resolution Inquiry Form, 2/00
Medicaid Resolution Inquiry, 4/00
Medicare Crossover Reference Request, 2/00
Modifications to the Automated Voice Response System through the ITME Project, 10/00
Modifier 25 and Minor Procedures, 8/00
Modifier 79 and Multiple Session Procedure Codes, 9/00
North Carolina Electronic Claims Submission Software, 1/00
Pap Smear Billing Changes, 5/00
PCG Medicare Recoupment Mailouts, 11/00
Penalties and Interest Assessments, 12/00
Pharmacy Adjustment Request Form, 8/00
Physical, Occupational and Speech Therapy, and Developmental Evaluation Center Services, 10/00
Preadmission Screening and Annual Resident Review Seminars, 3/00
Preventive Medicine Services, 6/00
Reimbursement of Inpatient Services Provided to Carolina ACCESS Enrollees, 9/00
Renovation of the MMIS System ITME Project, 4/00; 6/00; 9/00; 10/00; 11/00; 12/00
Reporting Electronic Commerce Services (ECS) Changes, 10/00
Resubmission of a Previously Denied Claim, 10/00
Resubmission vs. Filing Adjustment, 5/00
Special W-9, 1/00; 2/00; 10/00; 11/00; 12/00
Sterilization Guidelines, 6/00
Tax Identification Information, 10/00; 11/00; 12/00
Third Party Billing, 1/00
Update on Year 2000 Activities, 1/00
Venipuncture and Specimen Collection, 10/00
Where to Obtain Copies of the Federal Register, 10/00
*Special Bulletin I: CPT Code Conversion, 5/00
Anesthesia Providers
Individual Visits, 1/00
Monitored Anesthesia Care and Diagnosis Editing, 6/00
Adult Care Home Providers
Correction to Medicaid Special Bulletin Number VII, December 1999, 3/00
Increase in Reimbursement Rates, 12/00
Policy for Correcting the DMA-3050, 11/00
Ambulance Providers
Individual Visits, 3/00
CAP Providers and Case Managers
Reimbursement Rate Increase, 1/00; 2/00
Use of HCPCS Code W4655, 10/00
Carolina ACCESS Providers
Billing Procedures When a Carolina ACCESS Medicaid Recipient has been in an Accident, 6/00
Carolina ACCESS Emergency Room Claims Paid Prior to April 18, 2000, 10/00
Carolina ACCESS Expectations of Primary Care Providers, 7/00
Change in Billing Procedures for Urgent Care Centers, 9/00
Changes Made Within Your Practice, 1/00; 11/00
Mandatory Participation in Medicare and Medicaid for Carolina ACCESS Primary Care Providers, 11/00
Office Wait Times for Carolina ACCESS Primary Care Providers, 11/00
Chiropractor Providers
Chiropractor Visits, 6/00
CRNA and Anesthesiologist Providers
Billing for Dental Anesthesia, 12/00
Individual Visits, 1/00
Dental Providers
Changes to the Dental Program Effective July 1, 2000, 7/00
Conversion from Clinic Visit Medicaid Billings to ADA Coded Billings, 7/00; 9/00
Dental Seminar Schedule, 3/00; 4/00
Directions to the Dental Seminars, 4/00
New Dental Claim Form and Code Updates for the Year 2000, 5/00
Reimbursement Rate Increase, 1/00
Sample of the 1999 ADA Claim Form, 5/00; 7/00; 9/00
Dialysis Providers
Dialysis Termination Dates, 1/00
Dialysis Visits, 4/00
Durable Medical Equipment Providers
Addition of Code E0748 to DME Fee Schedule, 10/00
Addition of Tracheostomy Speaking Valve, 9/00
Change in HCPCS Codes for Supplies for Use with Nebulizers and Suction Pumps, 4/00
Coverage of Blood Glucose Monitors with Special Features, 1/00
Coverage of Diabetic Supplies, 7/00; 8/00
Directions to the DME and Basic Medicaid Seminars, 3/00
DME Seminar Schedules, 2/00; 3/00
New Coverage Criteria for Code E0747, 10/00
Rate Adjustment for Ambulatory Infusion Pump (E0781), 10/00
Rate Decrease, 11/00; 12/00
ECS Submitters
Electronic Filing Tips, 3/00
Family Practice Providers
Individual Visits, 8/00
Federally Qualified Health Center Providers
FQHC/RHC Visits, 7/00
Norplant Insertion Kit, 10/00
Health Check Providers
Coverage of Health Check Screenings Performed by Child Health Nurse Screeners, 9/00
Directions to the Health Check Seminars, 2/00
Health Check Billing Guide Error, 6/00
Health Check Next Screening Date Changes, 3/00
Health Check Seminars, 1/00; 2/00
Rate Increase: Health Check, 3/00
Health Departments
Directions to the Health Department Seminars, 4/00
Health Department Seminar Schedule, 4/00
Medication Administration Codes, 5/00
Norplant Insertion Kit, 10/00
Physical and Occupational Therapy Evaluations, 6/00
Questions from Health Department Workshops, 9/00
Supervision of Services Performed in Health Departments, 9/00
Health Department Dental Staff
Changes to the Dental Program Effective July 1, 2000, 7/00
Conversion from Clinic Visit Medicaid Billings to ADA Coded Billings, 7/00; 9/00
Dental Seminar Schedule, 3/00; 4/00
Directions to the Dental Seminars, 4/00
New Dental Claim Form and Code Updates for the Year 2000, 5/00
Reimbursement Rate Increase, 1/00
Sample of the 1999 ADA Claim Form, 5/00; 7/00; 9/00
Hearing Aid Providers
Coverage of Programmable Hearing Aids and FM Systems, 9/00
Dispensing Fee Adjustments, 10/00
Home Health Providers
Amendments to Home Medical Supply List, 1/00
Care Plan Oversight (CPO) of Medicaid Home Health or Hospice Services, 9/00
Correction to Billing Instructions for Skilled Nursing Visits Effective February 1, 2000 Date of Service, 3/00
Corrections to UB-92 Instructions in the October 1999 Revision of the Community Care Manual, 3/00
Coverage of Diabetic Supplies, 8/00
Directions to the Home Health Seminars, 1/00
HCPCS Codes for Skilled Nursing Providers, 5/00
Home Health Seminars, 12/00
Home Health Seminar Schedule, 1/00
Use of HCPCS Code W4655, 10/00
Home Infusion Therapy Providers
Home Infusion Therapy Visits, 6/00
Rate Adjustment for Ambulatory Infusion Pump (E0781), 10/00
Hospice Providers
Care Plan Oversight (CPO) of Medicaid Home Health or Hospice Services, 9/00
Corrections to UB-92 Instructions in the October 1999 Revision of the Community Care Manual, 3/00
FAQs About the Hospice Participation Reporting Requirements, 5/00
Hospice Participation Information on Automated Voice Response System, 3/00
Hospice Participation Reporting Requirements, 3/00
Hospice Rates, 1/00
Hospital Providers
Ancillary Services Paid without Prior Authorization, 1/00
Billing Emergency Room Visits Using Revenue Codes 450 and 451, 10/00
Billing Outpatient Diabetes Self-Management Training, 11/00
Billing Sterilizations on UB-92, 6/00
Carolina ACCESS Emergency Room Claims Paid Prior to April 18, 2000, 10/00
Directions to the Hospital Seminars, 6/00
Hospital Seminar Schedule, 5/00; 6/00
ICD-9 Procedure Code 47.09, 5/00
Interpreter Signature on Sterilization Consent Form, 4/00
Lower Level of Care and Swing Bed Reimbursement Rates, 12/00
Out-of-State Prior Approval Procedure for Acute and Rehabilitation Hospital Care, 10/00
Prior Approval Form, 10/00
Resident Supervision Requirements in Teaching Hospitals and Residency Programs, 6/00
Independent Practitioner Providers
Independent Practitioner Seminars, 8/00
Health-Related Services for Recipients Provided by Independent Practitioner (IP) Providers, 11/00
Postponement of the IP Seminars and Individual Visits, 9/00
Inpatient Psychiatric Hospital Providers
Reminder of Importance of Timely "Peer to Peer" Reviews, 12/00
Reimbursement Rate Increase, 1/00
Local Education Agencies Providers
Change of Documentation Requirements, 3/00
Mental Health/Substance Abuse Providers
A New Health Benefit, 5/00; 6/00
Clarification of Prior Approval Guidelines for Inpatients Applying for Medicaid During a Psychiatric Hospital Stay, 9/00
Direct Enrollment Seminars, 12/00
Incident to Policy for Licensed Clinical Social Workers and Clinical Nurse Specialists, 8/00
Individual Visits, 8/00
*Special Bulletin II: Mental Health and Substance Abuse Services Guidelines, 11/00
Nursing Facility Providers
Correction to the Medicaid Nursing Facility Provider Manual June 1, 2000, 9/00
Discharge of a Nursing Facility Resident, 5/00; 11/00
Level of Care Monitoring, 11/00
Nursing Facility Seminars, 7/00; 8/00
Preadmission Screening and Annual Resident Review (PASARR), 11/00
Utilization Review, 11/00
Nurse Practitioners
Norplant Insertion Kit, 10/00
Nurse Midwives
Norplant Insertion Kit, 10/00
OB/GYN Providers
Directions to the OB/GYN Seminars, 5/00
OB/GYN Seminars, 4/00; 5/00
Optical Providers
Confirmation/Prior Approval Reminder, 6/00
Directions to the Optical Seminars, 10/00
Optical Seminar Schedule, 9/00; 10/00
Reminder: Eye Refractions and Office Visits for Diabetic Patients, 11/00
Personal Care Service Providers
Corrections to UB-92 Instructions in the October 1999 Revision of the Community Care Manual, 3/00
Directions to the Personal Care Services Seminars, 7/00
Personal Care Services Seminars, 6/00; 7/00
Reimbursement Rate Increase, 1/00
Billing for Dental Anesthesia, 12/00
Care Plan Oversight (CPO) of Medicaid Home Health or Hospice Services, 9/00
Change to Injectable Drug List, 3/00
Correction to Injectable Drug List, 5/00
Coverage Criteria for Implantation of Patient-activated Cardiac Event Recorder, 4/00
Injectable Drug Fee Change, 5/00
Interpreter Signature on Sterilization Consent Form, 4/00
Medication Administration Codes, 5/00
Norplant Insertion Kit, 10/00
Out-of-State Prior Approval Procedure for Acute and Rehabilitation Hospital Care, 10/00
Patient Demand Single or Multiple Event Recording CPT 93268, 7/00
Physical and Occupational Therapy Evaluations, 6/00
Prior Approval Form, 10/00
Reimbursement Rate: Physician Fees, 1/00
Resident Supervision Requirements in Teaching Hospitals and Residency Programs, 6/00
Update to Injectable Drug List, 4/00; 6/00; 10/00; 11/00
Conversion from UPIN Numbers to DEA Numbers, 1/00; 10/00; 11/00; 12/00
DEA Number Form, 2/00; 4/00; 10/00; 11/00; 12/00
DEA Number Required, 2/00; 4/00
Drug Utilization Review Section, 9/00
Synagis Coverage, 10/00
Private Duty Nursing Providers
Corrections to UB-92 Instructions in the October 1999 Revision of the Community Care Manual, 3/00
Individual Visits, 9/00
Use of HCPCS Code W4655, 10/00
Psychiatric Hospital Providers
Update on Continued Stay Review, 1/00
Rural Health Clinic Providers
FQHC/RHC Visits, 7/00
Norplant Insertion Kit, 10/00
Urgent Care Center Providers
Change in Billing Procedures for Urgent Care Centers, 9/00
EDS, 1-800-688-6696 or 919-851-8888
Attention: Nurse
Practitioners and Physician Assistants
Reducing Crossover Denials
When a recipient is eligible for both Medicare and Medicaid, Medicare automatically transmits claims electronically to the N.C. Medicaid program. These claims are known as crossover claims. Nurse practitioners and physician assistants employed by physicians have reported crossover claim denials.
Medicare requires nurse practitioners and physician assistants to bill all services not covered under Medicares "Incident To" policy under their own Medicare provider number.
Medicaid maintains a Medicare cross-reference file that is used to identify
the correct Medicaid provider. Nurse practitioners and physician assistants
must complete and return the form below to reduce crossover claim denials. Use
the Medicaid provider number of your physician employer(s) in the block titled
"Medicaid Provider number."
Medicare Crossover Reference Request Form
EDS, 1-800-688-6696 or 919-851-8888
All Providers
Pneumococcal Polysaccharide Vaccine (PPV23, CPT Code 90732) Billing Guidelines
The N.C. Medicaid program covers CPT code 90732 (PPV23). Due to the availability of this vaccine at no charge through the Vaccines for Children program (VFC), Medicaid will not reimburse for the vaccine for children through 18 years of age. Providers must, however, report PPV23 vaccine administration to Medicaid. CPT code 90732 must be listed on the claim with the appropriate modifiers.
Health departments must not bill an administration fee (W8012) if the vaccine Is given on the same day as a Health Check screening. Providers should bill W8010 (regular periodic screening) or W8016 (interperiodic screening) with 90732 and the appropriate modifiers.
Private physicians may bill an immunization administration fee (W8012) on the same day a vaccine is administered. Private-sector providers may bill an administration fee if it is the only service provided that day or if it is provided in addition to a Health Check screening or an office visit. Providers must bill the W8012 with CPT code 90732 and the appropriate modifiers.
Medicaid will reimburse providers for Medicaid-eligible recipients receiving PPV23 vaccine (CPT code 90732) after 18 years of age when diagnosis code V03.8 or V05.8 is submitted on the claim. The usual and customary charge should be listed for those recipients over 18 years of age. In order for the administration fee to be reimbursed by Medicaid, providers must bill CPT code 90782, "Therapeutic, prophylactic or diagnostic injection (specify material injected); subcutaneous or intramuscular."
Refer to the following table when billing for PPV:
|Under 19 years of age
|When Health Check screening is performed (vaccine is free):
|Bill W8010 or W8016; report 90732 with the appropriate modifiers. Do not bill W8012.
|Bill W8010 or W8016 and report CPT code 90732 with the appropriate modifiers. W8012 may be billed.
|Under 19 years of age
|When Health Check screening is not performed (vaccine is free):
|Report 90732 with the appropriate modifiers. Bill W8012.
|Report CPT code 90732 with the appropriate modifiers and bill W8012.
|Between 19 and 21 years of age
|When Health Check screening is performed:
|Bill W8010 or W8016 and CPT code 90732 with the appropriate modifiers and the usual and customary fee. Do not bill W8012.
|Bill W8010 or W8016 and CPT code 90732 with the appropriate modifiers and usual and customary fee. W8012 may be billed.
|Between 19 and 21 years of age
|When Health Check screening is not performed:
|Bill CPT code 90732 with the appropriate modifiers and the usual and customary fee. Bill W8012.
|Bill CPT code 90732 with the appropriate modifiers and usual and customary fee. Bill W8012.
|21 years of age and over
|When an evaluation and management code is billed:
|Bill CPT code 90732. Diagnosis code V03.8 or V05.8 must be on the claim. Do not bill an administration fee code.
|Bill CPT code 90732. Diagnosis code V03.8 or V05.8
must be on the claim. Do not bill an administration fee code.
|21 years of age and over
|When an evaluation and management code is not billed:
|Bill CPT code 90732 and administration fee code 90782. Diagnosis code V03.8 or V05.8 must be on the claim.
|Bill CPT code 90732 and administration fee code 90782. Diagnosis code V03.8 or V05.8 must be on the claim.
EDS, 1-800-688-6696 or 919-851-8888
All Providers
New Medicaid Identification Cards for Supplemental Security Income Recipients
In an effort to increase efficiency and improve security, Medicaid identification (MID) cards for Supplemental Security Income (SSI) recipients will be printed differently effective February 2001. The SSI population was selected because the MID cards are produced separately from other Medicaid recipients and because they are a relatively stable population. The new design will allow more flexibility in getting information to recipients. Also, the cards will be printed using the postal bar code, which is expected to improve delivery of the cards statewide. The cards will be printed on 8½ X 11 inch watermarked paper. The paper is a lighter weight, making it more pliable, and will be perforated allowing the recipient the ability to detach the card. However, the card is still valid if not detached. SSI recipients will receive notice in both January and February of 2001 regarding the new cards.
There is no change in the way recipients will use the cards. SSI recipients may, on occasion, receive cards printed on the heavier stock paper. These cards are still valid.
Renee Boston, Recipient and Provider Services, Medicaid Eligibility Unit
Attention: All
2001 CPT Updates
Effective with date of service January 1, 2001, Medicaid providers may bill the 2001 Current Procedural Terminology (CPT) codes. Claims filed with obsolete 2000 codes for dates of service January 1, 2001 through March 31, 2001 will be accepted. Dates of service on and after April 1, 2001 must be filed with 2001 CPT codes.
The following new 2001 CPT codes are noncovered:
36540 Collection of blood specimen from a partially or completely implantable venous access device
43752 Naso- or oro-gastric tube placement, necessitating physicians skill
44133 Donor enterectomy, open, with preparation and maintenance of allograft; partial, from living donor
44136 Intestinal allotransplantation; from living donor
69714 Implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; without mastoidectomy
69715 Implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator with mastoidectomy
69717 Replacement (including removal of existing device), osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; without mastoidectomy
69718 Replacement (including removal of existing device), osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator
77522 Proton treatment delivery; simple, with compensation
77525 Proton treatment delivery; complex
89321 Semen analysis, presence and/or motility of sperm
93668 Peripheral arterial disease (PAD) rehabilitation, per session
97532 Development of cognitive skills to improve attention, memory, problem solving, (includes compensatory training), direct (one-on-one) patient contact by the provider, each 15 minutes
97533 Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact by the provider, each 15 minutes
97602 Removal of devitalized tissue from wound; non-selective debridement, without anesthesia (e.g., wet-to-moist dressings, enzymatic, abrasion), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session
97802 Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes
97803 Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes
97804 Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes
99172 Visual function screening, automated or semi-automated bilateral
quantitative determination of visual acuity, ocular alignment, color vision
by pseudoisochromatic plates, and field of vision (may include all or some screening
of the determination(s) for contrast sensitivity, vision under glare)
The following procedure codes are under further review by the Division of Medical Assistance and are noncovered at this time.
90723 Diphtheria, tetanus toxoids, acellular pertussis vaccine, Hepatitis B, and poliovirus vaccine, inactivated (DtaP-HepB-IPV), for intramuscular use
90740 Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (3 dose schedule), for intramuscular use
90743 Hepatitis B vaccine, adolescent (2 dose schedule), for intramuscular use
67221 Destruction of localized lesion of choroid (e.g., choroidal neovascularization); photocoagulation (e.g., laser), one or more sessions
Italicized material is excerpted from the American Medical Association Current
Procedural Terminology. CPT codes, descriptions, and other data only are
copyrighted 2000 American Medical Association. All rights reserved.
EDS, 1-800-688-6696 or 919-851-8888
All Physicians and Hospital Providers
Clarification of the January 2000 Bulletin article "Reimbursement Rate: Physician Fees"
Effective with date of service January 1, 2000, the N.C. Medicaid program aligned with Medicare and adopted a new relative value method for calculating physician fees for facility-based services furnished in hospitals (inpatient, outpatient, and emergency rooms), ambulatory surgical centers (ASC), and skilled nursing facility (SNF) settings. This method is the facility-based fee concept.
The facility-based fee concept identifies two levels of practice expense relative value units (RVUs), facility and nonfacility, for each procedure code. The facility practice expense RVUs are used for services furnished in a hospital, SNF, ASC, mental health facility, and solely owned hospital physician practices. Bill outpatient hospital as the place of service for services rendered in a solely owned hospital physician practice.
The allowable for a specific procedure code is determined by the place of service, as indicated on the claim. There are numerous codes that are only performed by definition in a certain setting and will have only one level of practice expense. The fees for these procedure codes are the same for nonfacility and facility regardless of the place of service indicated on the claim.
EDS, 1-800-688-6696 or 919-851-8888
All Providers
Corrected 1099 Requests Action Required by March 1, 2001
Providers receiving Medicaid payments of more than $600 annually receive a 1099 MISC tax form from Electronic Data Systems Corporation (EDS). This 1099 MISC tax form is generated as required by IRS guidelines. It will be mailed to each provider no later than January 31, 2001. The 1099 MISC tax form will reflect the tax information on file with Medicaid as of the last Medicaid Checkwrite cycle date, December 15, 2000.
If the tax name or tax identification number on the annual 1099 MISC you receive is incorrect, a correction to the 1099 MISC can be requested. Correction ensures that accurate tax information is on file with Medicaid and sent to the IRS annually. When the IRS receives incorrect information on your 1099 MISC it may require backup withholding in the amount of 31 percent of future Medicaid payments. The IRS could require EDS to initiate and continue this withholding to obtain correct tax data.
A correction to the original 1099 MISC must be submitted by March 1, 2001 and must be accompanied by the following documentation:
Mail both documents to:
4905 Waters Edge Drive
Raleigh, NC 27606
Attention: Corrected 1099 Request - Financial
Upon receipt of the fax or mailed correction request, tax information on file with Medicaid will be updated according to the Special W-9 or IRS W-9. Tax information updates can be verified by checking the last page of each Medicaid Remittance and Status Advice (RA), which reflects both the provider tax name and tax identification number on file. Additionally, a copy of the corrected 1099 MISC will be generated and mailed for your record retention. All corrected 1099 MISC requests will be summarized and reported to the IRS as required.
EDS, 1-800-688-6696 or 919-851-8888
Attention: All
End-dated 2000 CPT Codes
Effective with date of service April 1, 2001, Medicaid providers may no longer
bill the procedure codes that are deleted by CPT. Claims filed with deleted
procedure codes for dates of service prior to April 1, 2001 will be accepted
for processing.
EDS, 1-800-688-6696 or 919-851-8888
Attention: All Providers
Mail Service Center Addresses
Effective January 2, 2001, all mail to the Division of Medical Assistance (DMA) must be addressed to the appropriate Mail Service Center address. Mail sent to any address other than the Mail Service Center addresses will not be forwarded and will be returned to the sender. Refer to the table below for DMAs Mail Service Center addresses.
UPS, FEDEX, Airborne, and other freight companies will continue to deliver to DMAs physical address, 1985 Umstead Drive, Raleigh NC, 27626. Include the DMA employees name and section with the address to ensure that the delivery is routed correctly.
If you are using forms that have not been updated with DMAs Mail Service Center
addresses, refer to the table below for the correct Mail Service Center address.
Division of Medical Assistance
2504 Mail Service Center
Raleigh, NC 27699-2504
Division of Medical Assistance
2507 Mail Service Center
Raleigh, NC 27699-2507
Division of Medical Assistance
2516 Mail Service Center
Raleigh, NC 27699-2516
Division of Medical Assistance
2519 Mail Service Center
Raleigh, NC 27699-2519
Division of Medical Assistance
2502 Mail Service Center
Raleigh, NC 27699-2502
Division of Medical Assistance
2022 Mail Service Center
Raleigh, NC 27699-2022
Division of Medical Assistance
2517 Mail Service Center
Raleigh, NC 27699-2517
Division of Medical Assistance
2512 Mail Service Center
Raleigh, NC 27699-2512
Division of Medical Assistance
2509 Mail Service Center
Raleigh, NC 27699-2509
Division of Medical Assistance
2505 Mail Service Center
Raleigh, NC 27699-2505
Division of Medical Assistance
2514 Mail Service Center
Raleigh, NC 27699-2514
Division of Medical Assistance
2513 Mail Service Center
Raleigh, NC 27699-2513
Division of Medical Assistance
2510 Mail Service Center
Raleigh, NC 27699-2510
Division of Medical Assistance
2511 Mail Service Center
Raleigh, NC 27699-2511
Division of Medical Assistance
2515 Mail Service Center
Raleigh, NC 27699-2515
Division of Medical Assistance
2506 Mail Service Center
Raleigh, NC 27699-2506
Division of Medical Assistance
2518 Mail Service Center
Raleigh, NC 27699-2518
Division of Medical Assistance
2508 Mail Service Center
Raleigh, NC 27699-2508
If you do not know which DMA section or units address to use, send your correspondence to the following general address:
(Name of DMA employee)
Division of Medical Assistance
2501 Mail Service Center
Raleigh, NC 27699-2501
Clarence Rogers, Financial Operations
Durable Medical Equipment (DME) Providers
Coverage of Negative Pressure Wound Therapy Pumps and Supplies
Effective with date of service January 1, 2001, negative pressure wound therapy
(NPWT) pumps are being added to the Frequently Serviced category of the DME
Fee Schedule. Supplies for use with the pumps will be added to the DME Related
Supply category of the DME Fee Schedule. NOTE: Coverage of these supplies when
monthly rental payments are being made is an exception to Sections 6.1 and 6.1.2
of the DME Manual (March 1, 1999 Reprint). The codes, maximum reimbursement
rates, and quantity limitations are as follows:
|negative pressure wound therapy electrical pump, stationary or portable
|dressing set for negative pressure wound therapy electrical pump, stationary or portable, each
|canister set for negative pressure wound therapy electrical pump, stationary or portable, each
Providers are expected to bill their usual and customary rates.
Prior approval is required for the pump. Medical necessity for the pump and supplies must be documented on the Certificate of Medical Necessity and Prior Approval form. Coverage criteria are as follows:
An NPWT pump and supplies are covered when the following criteria are met:
Ulcers and Wounds in the Home Setting:
The patient has a chronic Stage III or IV pressure ulcer, neuropathic (for example, diabetic) ulcer, venous or arterial insufficiency ulcer, or chronic (being present for at least 30 days) ulcer of mixed etiology. A complete wound therapy program described by criterion 1 and criteria 2, 3, or 4, as applicable depending on the type of wound, should have been tried or considered and ruled out prior to application of NPWT:
1. For all ulcers or wounds, the following components of a wound therapy program must include a minimum of all the following general measures, which should either be addressed, applied, or considered and ruled out to application of NPWT:
Initial authorization will be given for a maximum of 3 months.
An NPWT pump and supplies will be denied at any time as not medically necessary if one or more of the following are present:
1. On a regular basis,
Re-authorizations for continued coverage will be given for a maximum of 1 month.
If the continued coverage criteria are not fulfilled, continued coverage of the NPWT pump and supplies will be denied as not medically necessary.
For the purposes of this policy, a licensed medical professional may be a physician, physicians assistant, registered nurse, licensed practical nurse, or physical therapist. The practitioner should be licensed to assess wounds and/or administer wound care within the state where the beneficiary is receiving NPWT.
Lack of improvement of a wound, as used within this policy, is defined as a lack of progress in quantitative measurements of wound characteristics including wound length and width (surface area), or depth measured serially and documented, over a specified time interval. Wound healing is defined as improvement occurring in either surface area or depth of the wound.
The staging of pressure ulcers used in this policy is as follows:
|Stage I:
|nonblanchable erythema of intact light-toned skin or darker or violet hue in darkly pigmented skin.
|Stage II:
|partial thickness skin loss involving epidermis and/or dermis.
|Stage III:
|full thickness skin loss involving damage or necrosis of subcutaneous tissue that may extend down to, but not through, underlying fascia.
|Stage IV:
|full thickness skin loss with extensive destruction, tissue necrosis or damage to muscle, bone, or supporting structures.
Melody B. Yeargan, P.T., Medical Policy Section
Attention: All
Synagis Administration Billing Clarification
Synagis is billable through the pharmacy program under the guidelines most recently published in the October 2000 Medicaid Bulletin. When billing for Synagis administration, do not list a code for the drug itself. Use only the administration fee code 90782.
CPT code 90782 must be used to bill for administration of Synagis. The administration code is billable when the following conditions are met:
EDS, 1-800-688-6696 or 919-851-8888
Attention: Health
Frequently Asked Questions
Example: A family planning visit for a 19-year-old patient who meets this definition of new would be billed using 99385 (the new patient code for an individual of that age); an established patient of the same age is billed using 99395.
Example: Ms. R, age 24, is seen at a family planning clinic following delivery.
She receives her prenatal care from the health department. On the encounter
screen a "1" is entered in the field for "patient type" to indicate that she
is new to the family planning program. However, an established patient visit
is billed to procedure code 99395, because they have been seen in the agency
within the past three years.
If only general information is provided during the visit and the patient is scheduled to be seen in the future at the maternity clinic, the correct E/M procedure code to bill is 99211.
If the patient is seen by a physician, nurse practitioner or physician assistant
during the visit, bill the procedure code for the appropriate level of E/M
All Prescribers
Conversion from UPIN Numbers to DEA Numbers on Pharmacy Prescriptions and Claims
The Division of Medical Assistance (DMA) is now requiring DEA numbers on all recipient pharmacy claims instead of UPIN numbers. Providers must have their DEA registration number on file. Failure to do so may result in denied claims. If a prescriber does not have a DEA number and needs to issue prescriptions to recipients served by the Medicaid program, the prescriber should contact the DUR Section at 919-733-3590.
An identification number (ID) will be issued in lieu of the DEA number. The ID number, following the same format as the DEA number, will always begin with a Z (for example, ZF1234567). Prescribers will need to enter this number on their Medicaid prescriptions. This number is referred to as a MEDICAID IDENTIFICATION NUMBER only and should not be referred to as a DEA number.
If EDS Provider Enrollment does not have your updated information, please copy, complete, and return the DEA Number form for each prescriber in your practice. Please send the information to the following address:
EDS Provider Enrollment Unit
P.O. Box 300009
Raleigh, North Carolina 27622
EDS, 1-800-688-6696 or 919-851-8888
DEA Number form
Sharman Leinwand, DUR Coordinator, Program Integrity
DMA, 919-733-3590 ext. 229
Attention: All Providers
Renovation of the MMIS System Identification Tracking Measurement Enhancement (ITME) Project
The Division of Medical Assistance (DMA) is upgrading and enhancing the Medicaid Management Information System (MMIS). The goals of the renovation, as noted in the April, 2000 Bulletin, are:
Changes to the following parts are detailed in the Provider Impact section of this article.
Part I - Remittance and Status Advice
Part II - Adjustment Requests NEW FORM
Part III - Prior Approval (PA)
Part IV - Automated Voice Response (AVR) System and Eligibility Verification System (EVS)
Implementation Schedule
Updated Implementation Date: The implementation of system changes for the ITME project has been extended to February 9, 2001. The revised date of February 9, 2001 supercedes the original implementation date reflected in the September and October, 2000 ITME bulletin articles. Please note that all references to effective dates in the remainder of this article have been revised to reflect the extended date of February 9, 2001.
The RA will reflect the changes noted in Part I beginning February 9, 2001. Part II reflects the new N.C. Medicaid adjustment form. Use of this form is required as of February 9, 2001. Part III provides new instructions for submitting services that have been prior approved. Part IV addresses changes to the AVR System and EVS resulting from this enhancement.
Provider Impact
Part I: Remittance and Status Advice (RA) - See
Example 1
RA modifications/format changes will be kept to only those that are necessary in conjunction with the ITME project. Overall, the RA will look very similar to the current format. Please note the format changes on the RA sample following this article (Example 1).
Addition of Financial Payer Code
A financial payer code follows the claim internal control number (ICN) in the first line of the claim data reflected on the RA. This financial payer code denotes the entity responsible for payment of the claims listed on the RA. Upon implementation, N.C. Medicaid will be the only financially responsible payer; therefore, the N.C. Medicaid payer code of NCXIX (five characters) will be reflected.
Addition of Population Group Payer Code
The RA reflects the population payer code for each claim detail. The population payer code is printed at the beginning of each claim detail line on the RA. The population payer code denotes the special program/population group from which a recipient is receiving Medicaid benefits. Examples of population payer codes are as follows:
|Carolina ACCESS
|All recipients enrolled in Medicaids Carolina ACCESS program
|All recipients enrolled in Medicaids ACCESS II program
|ACCESS III Cabarrus County
|All recipients enrolled in Medicaids ACCESS III program for Cabarrus County
|ACCESS III Pitt County
|All recipients enrolled in Medicaids ACCESS III program for Pitt County
|Health Management Organization (HMO)
|All recipients enrolled in Medicaids HMO program
|All recipients not enrolled in any of the above noted population payer programs. Any recipient not identified with Carolina ACCESS, ACCESS II, ACCESS III, or HMO will be assigned the NCXIX population payer code to identify them with the Medicaid fee-for-service program.
Other population payers may be designated by DMA in the future.
Addition of new totals following the current claim total line
An additional line is added following each claim total line of the paid and denied claim sections of the RA for the following claim types: Medical (J), Dental (K), Home Health, Hospice and Personal Care (Q), Medical Vendor (P), Outpatient (M), and Professional Crossover (O). This additional line reflects original claim billed amount, original claim detail count, and total number of financial payers. Upon implementation in February, 2001, N.C. Medicaid will be the only financial payer; these new totals will reflect the submitted claim totals.
These additional totals do not appear for claim types Drug (D), Inpatient (S), Nursing Home (T), and Medicare Crossover (W) since they are not processed at the claim detail level and will not have multiple financial payers assigned, based on current N.C. Medicaid billing policy.
Addition of a new summary page at end of RA
For each Medicaid population payer identified on the paper RA, a new summary page showing total payments by population payer is provided at the end of the RA. This provides population payer detail information for tracking and informational purposes.
New specifications for Tape RA
Updated specifications have been mailed to all Tape RA Providers. If you are currently receiving a Tape RA and have not received the updated specifications, or have questions regarding the changes, please contact Glenda Raynor, Manager of EDS Electronic Commerce Services, at 919-851-8888 extension 5-3099.
Part II: Adjustment Requests NEW FORM - See
Example 2
The N.C. Medicaid program will begin using a new RA format in February, 2001. This new format affects the way adjustment request forms are completed by the provider and processed by EDS. The appropriate "financial payer" information found on the new RA will be required on all adjustment request forms after February 9, 2001. DMA and EDS have implemented a new adjustment request form to help with these changes. One of the predominant changes is in the "claim number" field. This area is now identified with twenty boxes, each box for one number of the referenced claim number. Until February 9, 2001, there will be five empty boxes at the end of the claim number. After the February 9, 2001 implementation of the MMIS enhancements, these spaces will be used for the financial payer code information. Providers may begin using this new adjustment request form now if it facilitates implementing these changes. (Refer to example of claim field below.) Please contact EDS Provider Services with questions about the new format and processing of an adjustment request.
Claim #:
Claim #:
Part III: Prior Approval (PA)
Effective February 9, 2001, entering the prior approval number on the claim form by the provider to receive payment for services rendered will no longer be required. This holds true for all prior approved Medicaid services, regardless of the entity giving the prior approval.
Prior approval requirements and the criteria for approval of services have not changed. Those services that previously required prior approval before the implementation of the enhanced MMIS will continue to require prior approval. If a service was approved prior to February 9, 2001 but was not provided or billed until after February 9, 2001, the original prior approval is still valid. The MMIS will verify that prior approval was obtained before claims payment can occur. If the services being submitted on the claim form require prior approval, and approval has not been obtained, that claim will be denied. The only change is that the input of the prior approval number is no longer required on the claim form by the provider as of February 9, 2001.
Part IV: Automated Voice Response (AVR) System and Eligibility Verification
System (EVS)
These systems will be enhanced with new messages that will explain under which special Medicaid program or programs a recipient is enrolled as a participant. Additional information regarding these system enhancements will be provided in subsequent bulletin articles.
EDS, 1-800-688-6696 or 919-851-8888
Attention: All
Coverage of Apligraf, Q0185
Effective with date of service November 1, 2000, the N.C. Medicaid program covers Apligraf. HCPCS code Q0185, dermal and epidermal tissue of human origin, per square centimeter, must be used when billing this material. The code must be billed in conjunction with codes that describe application of the tissue and preparation of the site.
Use the following codes to bill the application of Apligraf and preparation
of the site.
November 1, 2000
December 31, 2000
Application of tissue cultured skin graft, initial 25 sq cm
Application of tissue cultured skin graft, each additional 25 sq cm
January 1, 2001 or after
Application of bilaminate skin substitute/neodermis; initial 25 sq cm
Application of bilaminate skin substitute/neodermis; each additional 25 sq cm
Italicized material is excerpted from the American Medical Association Current
Procedural Terminology. CPT codes, descriptions, and other data only are
copyrighted 2000 American Medical Association. All rights reserved.
EDS, 1-800-688-6696 or 919-851-8888
Nursing Facility Providers
Request for Retroactive Prior Approval
Effective January 1, 2001, nursing facilities may request consideration of retroactive prior approval for nursing facility (NF) level of care with the initial FL2 submission to EDS. If the retroactive request is within thirty (30) days from the telephone prior approval or FL2 criteria review, medical records may not be needed by EDS to make a level of care decision. If the retroactive request is for a time period exceeding thirty (30) days, medical record documentation will be required by EDS to support the retroactive request and level of care decision.
EDS will also consider retroactive prior approval requests in the following instances:
Nursing Facility Providers
Preadmission Screening and Annual Resident Review
Effective January 1, 2001, all nursing facility residents must have a First Health (formerly First Mental Health) PASARR number. Residents who were "grandfathered" in with PASARR forms used prior to February 1994, must be screened and receive a PASARR number from First Health (FH) by the effective date.
Tracking forms must be sent to FH for all new admissions in order for the receiving facility to obtain a copy of the Level I and, if appropriate, the Level II results. Level I and Level II documentation must be kept in the residents medical record.
FH authorization numbers end with an "alpha" character. The following is an explanation of the alpha characters:
A Nursing facility placement appropriate, does not meet target population for mental illness (MI), mental retardation (MR), or related condition (RC).
B Nursing facility placement appropriate, no specialized services required. An annual resident review is required.
C Nursing facility placement appropriate, specialized services required. An annual resident review is required.
D Represents 7-day time-limited approvals.
E Represents 30-day time-limited approvals.
F Represents 60-day time-limited approvals.
H Halted Level II review. Does not meet MI or MR definitions
J Residents approved for admission only to state psychiatric hospitals.
Z Denial for placement in a nursing facility.
NOTE: The D, E, and F alphas indicate time-limited stays and the prior approval (PA) number issued by EDS for level of care is also time-limited. Payment will be denied when the PA number is end-dated. Residents who have PASARR numbers with these alpha characters must be closely monitored. If a resident needs to remain in the facility beyond the specified time limit, a Level II screening must be initiated through FH. Payment will be denied for each day past the time-limited stay. For time-limited stays E and F, a new FL2 must be submitted to EDS as soon as the facility receives the new PASARR number.
Margaret O. Langston, RN, Institutional Services, Medical Policy Section
All Providers
Non-emergency Transportation by Nursing Facilities and Adult Care Homes
This article clarifies the responsibility that nursing facilities and adult care homes have when a Medicaid recipient requires medically necessary non-emergency transportation. This situation may arise, for example, when a Medicaid recipient needs to be transported to a physicians office or from an emergency department back to the facility.
According to the North Carolina Medicaid State Plan, since October 1, 1994, nursing facilities have been responsible for medically necessary non-emergency transportation for residents, unless ambulance transport is required. The cost of this service is reimbursed under the facilitys direct rate, as written in the State Plan, Section 4.19 (d), Attachment 4.19-D .0102 (I):
Adult care homes are responsible for assuring that residents are transported
to necessary resources and activities, including transportation to the nearest
appropriate health facilities, according to the licensure rules by which the
home is licensed. These facilities are also reimbursed for this service under
the adult care home transportation rate by the N.C. Medicaid program.
EDS, 1-800-688-6696 or 919-851-8888
Attention: Nursing
Facility Providers
Tracking Forms: A Major Part of the Preadmission Screening and Annual Resident Review Process
To assure compliance with the federally mandated Preadmission Screening and Annual Resident Review Process (PASARR) requirements, all Medicaid-certified nursing facilities must complete the PASARR Tracking form for every admission, regardless of pay source, and forward it to First Health (FH), the Division of Medical Assistances contractor for the PASARR process. The information documented on the Tracking form communicates to FH the name of the admitting facility and ensures that the facility will receive a copy of the Level I and, if appropriate, Level II screening results.
The requirements also mandate that when a screening has not been completed prior to admission or an annual review is not performed within the fourth quarter after the previous preadmission screen or annual resident review, Medicaid reimbursement must be denied. Once the Level I, and, if appropriate, the Level II screen is completed, Medicaid reimbursement will resume.
The Level I or Level II screening results must be kept in the residents medical record to allow availability to the facilitys care planning team and to federal and state auditors.
Tracking forms must be completed for the following:
1. All first time admissions in the Level I process:
Margaret O. Langston, RN, Institutional Services, Medical Policy Section
Home Health Providers
Home Health Seminar Schedule
Seminars for Home Health providers are scheduled for February 2001. Each provider is encouraged to send new or appropriate administrative, clinical, and clerical personnel. The primary topic will be the new guidelines for whether the service is medically necessary and appropriate in the home setting. The agenda will also include Program Integrity issues, commonly identified Home Health program errors, a review of procedures for filing home health claims, common billing errors, and follow-up procedures.
Due to limited seating, preregistration is required. Unregistered providers are welcome to attend when reserved space is adequate to accommodate. Please select the most convenient site and return the completed registration form to EDS as soon as possible. Seminars begin at 10:00 a.m. and end at 1:00 p.m. Providers are encouraged to arrive by 9:45 to complete registration.
Return the Home Health Provider Seminar Registration Form to:
Provider Services
P.O. Box 300009
Raleigh, NC 27622
Note: Providers are requested to bring their most updated Community Care manual. Additional manuals will be available for purchase at $20.00. (The updated Community Care manual includes the January 1999 reprint, the October 1999 revision, and the October 2000 revision.)
Directions to the sites
|Thursday, February 1, 2001
Four Points Sheraton
5032 Market Street
Wilmington, NC
|Tuesday, February 6,
Martin Community College
Kehakee Park Road
Williamston, NC
|Tuesday, February 13, 2001
Catawba Valley Technical College
Highways 64-70
Hickory, NC
|Tuesday, February
20, 2001
Holiday Inn Conference Center
530 Jake Alexander Blvd., S.
Salisbury, NC
|Tuesday, February
27, 2001
MEI Conference Center
3000 New Bern Avenue
Raleigh, NC
to the Home Health Seminars
Traveling North on I-85
Take exit 75. Turn left onto Jake Alexander Boulevard. Travel approximately ½ mile. The Holiday Inn is located on the right.
Parking is available at the former CCB Bank parking lot, a short walk to the conference facility. The entrance to the Conference Center is at the top of the stairs to WakeMeds Medical Education Institute.
Parking is also available on the top two levels of Parking Deck P3. To reach this deck, exit the I-440 Beltline at exit 13A. Proceed to the Emergency entrance of the hospital (on the left). Follow the access road up the hill to the gate for Parking Deck P3. After parking in P3, walk down the hill past the Medical Office Building and past the side of the Medical Education Institute. Turn right at the front entrance of the building and follow the sidewalk to the Conference Center entrance.
Illegally parked vehicles will be towed. Parking is not permitted at East Square Medical Plaza, Wake County Human Services, the P4 parking lot or in front of the Conference Center.
Attention: Licensed
Psychologists, Licensed Clinical Social Workers, Certified Child and Adolescent
Psychiatric Nurse Practitioners, Certified Child and Adolescent Psychiatric
Clinical Nurse Specialists
Independent Mental Health Provider Seminars
Effective February 1, 2001, the Division of Medical Assistance will begin enrollment of Independent Mental Health providers in the N.C. Medicaid Program. This direct enrollment will be for independent providers in a solo or group practice for the provision of mental health services to Medicaid-eligible children ages birth through twenty.
Seminars for Independent Mental Health Providers are scheduled for February 2001. These seminars will focus on Medicaid guidelines for direct enrollment of Licensed Psychologists, Licensed Clinical Social Workers, Certified Child and Adolescent Psychiatric Nurse Practitioners, and Certified Child and Adolescent Psychiatric Clinical Nurse Specialists. Other topics will include covered services, reimbursement rates, and billing instructions.
Due to seating limitations, registration for group practices is limited to one registrant per practice. Unregistered providers are welcome to attend when reserved space is adequate to accommodate. Seminars begin at 10:00 a.m. and end at 1:00 p.m. Providers are encouraged to arrive by 9:45 a.m. to complete registration.
Please select the most convenient site and return the completed registration form to EDS no later than January 22, 2001. Please be sure to complete all the blocks of the registration form to expedite registration. Should your chosen site no longer have available seating, you will be notified and offered registration at an alternate location.
Return the Independent Mental Health Provider Seminar Registration Form to:
Provider Services
P.O. Box 300009
Raleigh, NC 27622
Directions to the sites
|Thursday, February 8, 2001
A-B Technical College
340 Victoria Road
Asheville, NC
Monday, February 12, 2001
Brody Science Building
Brody Auditorium
(Blue Section)
Greenville, NC
|Thursday, February 15, 2001
Holiday Inn
530 Jake Alexander Blvd., S.
Salisbury, NC
Monday, February 19, 2001
Coastline Convention Center
501 Nutt Street
Wilmington, NC
Thursday, February 22, 2001
McKimmon Center
Raleigh, NC
Directions to the Independent Mental Health Provider Seminars
Stay on Victoria Road. Turn right between the Holly Building and the Simpson Building. The Laurel Building/Auditorium is located on the right, behind the Holly Building.
Traveling North on I-85
Take exit 75. Turn left on Jake Alexander Boulevard. Travel approximately ½ mile. The Holiday Inn is located on the right.
Traveling West on I-40
Take exit 295 and turn right onto Gorman Street. Travel approximately one mile. The McKimmon Center is located on the right between Avent Ferry Road and Western Boulevard.
Electronic claims must be transmitted and completed by 5:00 p.m. on the
cut-off date to be included in the next checkwrite. Any claims transmitted after
5:00 p.m. will be processed on the second checkwrite following the transmission
|Paul R. Perruzzi, Director
|John W. Tsikerdanos
|Division of Medical Assitance
|Executive Director
|Department of Health and Human Services


text:
|Swap Shop: 08/29/12
|Written by Noah Lockamy
|Wednesday, 29 August 2012 13:00
For Sale: 2 clarinets good shape, Yard sale items for sale,$70.00 for everthing toys, 13in color tv, decorations, call 297-4254
To Give Away: Free: 4 month old rooster from McMurray Hatchery. Wormy chestnut for sale. Call 297-5463 for more information.
For Sale: A coffee and 2 end tables a cherry finish. $60.00 or Best Offer. A Columbia coat size large, blue with white trim. Very good condition.$40.00. Call after 4pm 828-963-6608 you can leave a message.
Yard Sale: Multi family yardsale on Saturday 09/01/12 located in the Moose Lodge paking lot. Tools-ceiling fans-clothes-books and misc items. 7:00 a.m. until noon!!!!
|Share This Article:


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In the Beginning
These opening two verses of Scripture introduce us to the One for whom and by whom all things were made. The self-existent Lord of the universe existed before everything was created, and He alone has the ability to create freely ...Read More
He Who Was Born of God
Because we all know sin still remains in us, these verses claiming true children of God do not keep on sinning can be disheartening at times. Yet, as we have often seen, John does not teach that Christians can be ...Read More
God is Love
When we say "God is love" we must never think His love is more important than His other attributes. The doctrine of God's simplicity tells us God's love never operates apart from His holiness, mercy, justice, omnipotence, omniscience, or any ...Read More
The Trinity
Many Christians misunderstand the doctrine of the Trinity. It is therefore vital that we understand it in order to confess it rightly. It preserves God's independence, meaning He did not need to create the world in order to be in ...Read More
God Our Father
The misunderstanding of the love and fatherhood of God that is so prevalent in our culture makes it hard for us to speak of these concepts and be heard rightly. As we seek to emphasize other biblical concerns like God's ...Read More
No Darkness At All
Many non-Christian scholars of religion stress the difference between man and God to such a degree that they end up saying we cannot truly know anything about Him at all. The incarnation affirms that despite the Creator's transcendence, God has ...Read More
Vessels of Destruction
Many misunderstand Reformed theology to say that God forces some to go to hell against their will. Though God does indeed pass over some people, He never acts apart from their desires. In our natural state since the fall, all ...Read More
The Restrainer
Knowing the identity of the restrainer mentioned in today's passage would indeed be a good thing for our understanding of this text. However, whether or not we are ever clear of the identity of this restrainer, the important point of ...Read More
God and Time
We gain a helpful perspective on prayer by remembering that God's relation to time is different than our own. It can be easy to grow impatient when God takes years to answer prayer. If we are not careful, we can ...Read More
Condemned to Extinction
The Bible is filled with contrasts between the ways of the righteous and the ways of the wicked. Though only the perfect righteousness of Christ can justify a person, those who have been justified endeavor to obey God's righteous law. ...Read More
DevotionalsDaily readings to encourage your heart and mind in the pursuit of God and his glory.
- All
- Angels and Demons
- Atonement
- Basic Reformed Theology
- Irresistible Grace
- Limited Atonement
- Perseverance of the Saints
- Total Depravity
- Unconditional Election
- The Church
- Church Discipline
- Church Leadership
- Creeds and Confessions
- God
- Holiness
- Sovereignty
- Heaven and Hell
- Heresies
- The Holy Spirit
- Jesus Christ
- Cross
- Incarnation
- Resurrection
- Justification
- Last Things
- Man and Sin
- Sacraments
- Salvation
- Faith
- Regeneration
- Scripture
- Systematic Theology
- Theological Views
- Roman Catholicism
- Music
- Apologetics
- False Teaching
- Atheism
- Christianity and Culture
- Creation
- Ethics
- Fiction and Literature
- Philosophy
- Science
- Bible Figures
- Bible Interpretation
- Bibles
- Books of the Bible
- Gospels
- Covenants
- General Reference Works
- Introduction to the Bible
- Jesus' Ministry
- Life of Jesus
- New Testament
- Old Testament
- Parables
- Prophecy
- Sermon on the Mount
- Ten Commandments
- The Lord's Prayer
- Controversies in the Church
- Arts
- Bible Translation
- Covenant Theology
- Creationism
- Education
- Inclusivism
- Law and Gospel
- Lordship Salvation
- Politics
- Sabbath
- Spiritual Gifts
- Stewardship of Creation
- Theonomy
- Women in Ministry
- Marriage and Family
- Divorce
- Parenting
- Practical Theology
- Discipleship
- Evangelism and Missions
- Grief and Death
- Pastoral Ministry
- Preaching
- Worship
- Spiritual Growth
- Anxiety and Worry
- Apostasy
- Assurance
- Conscience
- Depression
- Doubt
- Fellowship
- Godliness
- Guilt
- Humility
- Joy
- Knowing God's Will
- Legalism
- Love
- Money and Stewardship
- Oaths and Vows
- Prayer
- Pride
- Repentance and Forgiveness
- Sanctification and Growth
- Service
- Spiritual Fruit
- Suffering
- Thankfulness
- Vocation
- Ancient Church
- Biography
- Enlightenment and Modernism
- Historical Theology
- Reformation
- Twentieth Century


text:
- Northern New York Newspapers
- Watertown
- Ogdensburg
- Massena-Potsdam
- Lowville
- Carthage
- Malone
- NNY Business
- NNY Living
- NNY Ads
HOGANSBURG The federal trial of five men accused of multiple offenses in connection with a non-tribal gambling parlor on the St. Regis Mohawk Reservation has been pushed back to at least May, while a defense attorney on Wednesday petitioned the court for the pretrial release of one defendant.
Hogansburg residents James Gray, William Roger Jock, Anthony L. Laughing Sr. and Thomas Angus Square, together with Joseph Hight of Atlanta, face charges following a multiagency raid on the shuttered Three Feathers Casino in December.
The federal government alleges the men conducted an illegal gambling business and unlawfully possessed gambling devices in Indian country in connection with operation of the casino, which opened in July 2011. The Route 37 casino apparently shut down in September, but investigators say it continued to draw power from National Grid through an illegal electrical connection that was severed during the Dec. 18 raid.
A trial had been set for Feb. 11 in Utica, but U.S. District Judge David N. Hurd earlier this month signed an order moving the trial date to May 13 to give defense and prosecution adequate time to prepare for the proceeding.
On Wednesday, meanwhile, Manhattan attorney Scott Michael Moore filed a motion to modify the conditions of pretrial release set for Mr. Square, who has been held at the Clinton County jail, Plattsburgh, since his arrest Dec. 18.
According to Mr. Moores motion, a Dec. 21 request to modify the terms was denied Dec. 31 by U.S. District Court Judge Larry A. Kudrle.
Mr. Moore wrote that the defendants valuation of $500,000 of his real estate was the primary basis for the $50,000 cash bail set for his release. Information subsequently provided by Mr. Squares wife, Jean, suggested that even if the property could be mortgaged, the value would be more in the area of $60,000, Mr. Moore wrote. He also argued that Mr. Square poses a low likelihood of flight because of his position to fulfill his traditional governmental duties as the Wolf Clan Mens Council representative to the tribal longhouse.
The attorney concluded by asking the court to consider releasing Mr. Square on his own recognizance or on unsecured appearance bond.
Of the other defendants, Mr. Laughing was released on a $50,000 bond with electronic monitoring, while Mr. Jock and Mr. Hight were released on a $10,000 bond each. Documents filed Feb. 19 indicated Mr. Gray was still a fugitive.
Thousands of readers like you have made Northern New York Newspapers the number one ranked website* for local news and sports coverage in the north country.
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text:
By JOHN SERFUSTINISun Advocate associate editor
As a result of legislative redistricting, it will be 459 road miles from the northernmost part of Sen. David Hinkins' District 27 to the point farthest south. And that's if he or his successor takes the shortest route.
However, the Orangeville Republican is not complaining. District 27 will remain rural and won't be outweighed by urban interests, he explained. Hinkins has kept Carbon, Emery, Grand and San Juan counties and part of Utah County. His district has added a sliver of Wasatch County, also.
District 27 has lost parts of Spanish Fork in Utah County on the new legislative map but has kept Mapleton and added Springville. In addition, Charleston and Daniel, both small towns in Wasatch County near Deer Creek Reservoir, have become part of the large district.
It's the hypothetical drive from Charleston to Navajo Mountain in the southwest corner of San Juan County that makes for the long road trip, mainly because the route has to drift south into Arizona to get to the isolated desert area. A more reasonable drive, say from Charleston to Blanding, would be only 289 miles.
"It's a long district, but the Carbon-Emery area is right in the middle," Hinkins said, which to him means Castle Country will continue to be influential. While Carbon-Emery is not exactly next door to the northern- and southernmost parts of the region, it is close enough to each to provide balanced representation for the whole territory.


text:
By Aldo Panessidi
Microsoft's new Window Phone 8 OS won't get installed on any of the current Windows Phone devices because they are based on a different core- Windows CE (Windows Phone 7) versus Windows NT (Windows Phone 8). Windows Phone 8 will support significant improvements including multiple CPU cores and better graphics.
Microsoft's senior marketing manager for Windows Phone Greg Sullivan stated that, while it can be done, porting WP8 on older devices would be very expensive. He also stated that the WP8 requires functions like multi-core support, higher resolution screens, NFC and microSD card support. The legacy device hardware can't make use of Windows Phone 8 upgrades.
Microsoft is attempting to make it up to current Windows Phone users with a Windows Phone 7 update (WP 7.8). It's most noticeable change is a more user-friendly Start screen.
Users who buy Windows Phone 8-compatible devices, will be able to migrate their Windows Phone 7 apps. There's no backwards compatibility for the newly developed WP8 apps though and there's nothing that can be done about it.
This could mean a big loss of momentum for Microsoft's mobile OS. They're still the new kid on the block trying to establish a reputation. This isn't helping.


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The Enduro World Series in Val d'Isère was an epic week-end! This 6th round was the decisive race: if Jey finished in front of Jared Graves, he would have enough points to win the overall of the World Enduro series!
The race started with a very technical and steep downhill on Saturday morning: Jey had hard time to get into it. In the first 2 runs, he finished 4th and then 5th, behind the winner of them, Jared, with 20 seconds gap after 2 stages. Then a big storm happened and the conditions totally changed: mud, fog and cold temperatures. The organisation decided to keep only one run. Jey preferred this 2nd stage because it was long, and very natural: trial sections on the top and some physical in the middle. He took the risk to use mud tires and was one of the only to choose these set. He felt confident on the track, rode fast ans sidewyas to gain the stage with 44 seconds advanced in front of Jared. He end it up with the 1st place at the end of the day!
On Sunday, the snow was with us in the start! On the 1st run, Jey windened the gap with Jared by winning with 27 seconds advanced. But it was not over: the last stage was extremely physical and long (17'). Jared had to push hard to grab his last chance to catch back Jey. But Jérôme played it well with a good balance between safety and risk to resist from the strong come back of Jared. They finished together on the line, but that enough to keep 11 seconds advantage!
You can find the result here : http://www.enduroworldseries.com/downloads/results/val-dIsere-Men.pdf
Jey also won the nationals with the French team : Fabien Barel and Rémy Absalon!!
Jérôme wins the overall and becomes the 1st Enduro World Champion! He is really proud to share this victory with you and would like to thank you for your amazing support.
Pauline was really happy of her results: she finised 5th! And she won the girl enduro nationals ranking with the French team: Anne-Caroline Chausson and Cécile Ravanel! What a great week-end!
Pictures - ©quentinendurotribe