A. Caseworkers will enter code 9999903 if they have been unable to contact a dual eligible (Medicaid/Medicare) recipient to explain and offer enrollment in CCNC/CA. This code is only used for Medicare recipients.
D. Caseworkers will enter code 9900647 if no provider is available for the recipient to choose for a PCP within a 30 mile radius from the recipient’s home and the recipient does not choose a PCP at a greater distance.
Manual: Family and Children’s Medicaid
Change No: 13-10
To: County Directors of Social Services
In order to assist caseworkers in using the correct code when exempting a recipient from CCNC/CA, revisions are made in policy and procedures regarding exemptions codes, 9900646, and 9900647. These new codes and procedures will be effective 11/01/2010.
MA-3435, Community Care of North Carolina/Carolina ACCESS (CCNC/CA), is
revised to include new manually entered exemption codes, 9900646 and 9900647 and their definition description. In addition, exemption code 9999903 is updated with a new definition description.
This policy is effective 11/01/2010. Apply this change to applications taken and redeterminations started on or after 11/01/2010, as well as to those presently in process.
If you have any questions regarding this information, please contact your Medicaid Program Representative.
Craigan L. Gray, MD, MBA, JD,
(This material was researched and written by Betty West, Customer Service Manager, Managed Care Unit and Sandi Morrow, Medicaid Program Consultant, Medicaid Eligibility Unit)
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.