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Provider Digest | Volume 129

Date: 06/26/24

Effective July 1, 2024: New Doula Billing Codes for Trillium Medicaid Claims

Effective July 1, 2024, the Oregon Health Authority (OHA) is implementing new billing codes for doula services. Once this change takes place, you will use the same CPT code (T1033) for the global birth doula package, the itemized two (2) prenatal and two (2) postpartum visits, and the doula services day of delivery only. However, it’s important to use the correct modifier for correct billing as noted below:

New Billing & Coding

  • T1033 with HD modifier one (1) time for a global birth doula package (delivery with two (2) prenatal and two (2) postpartum visits)
  • T1033 with No modifier for Support visit (two (2) prenatal and two (2) postpartum visits)
  • T1033 with 22 modifier for Doula services day of delivery only

Trillium Community Health Plan will be accepting claims using the old billing codes through June 30, 2024. We will require the new billing codes beginning July 1, 2024. 

If you have any questions about the new doula billing codes, please reach out to your assigned health plan Provider Engagement Representative or your Traditional Health Worker (THW) Liaisons:

Resources

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Responses Due July 15, 2024: Trillium Medicaid Bi-Annual Capacity Review

Have you completed the Trillium Provider Capacity Survey yet?

Oregon Health Authority (OHA) requires Trillium to report in-network provider capacity on a bi-annual basis to ensure members in our communities have access to high-quality healthcare. The survey is only four questions and takes  approximately 2 minutes to complete.

Please take the survey by July 15, 2024.

Thank you for your partnership in helping our members stay healthy!

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Trillium Community Health Plan Partners with Song for Charlie to Address Epidemic of Youth Fentanyl Overdose Deaths

According to the Centers for Disease Control and Prevention (CDC)1, from 2018 to 2022, nearly 300 Oregonians aged 15 to 24 died from drug overdose and poisoning. During this timeframe, the rate of drug-related deaths in Oregon increased more than sixfold, marking the fastest growth in teen drug deaths compared to any other state. This surge has positioned Oregon as having one of the highest teen drug death rates in the country. Notably, all of Oregon’s teen drug deaths in 2022 were linked to synthetic opioids, such as fentanyl.

To support families and communities in tackling the drug overdose epidemic, Trillium has invested $1 million to adapt Song for Charlie’s prevention materials for Oregonians at no cost. This investment includes "The New Drug Talk,” a free online resource that helps parents and educators talk with youth about the dangers of fentanyl, counterfeit pills, and today’s drug environment. The site includes videos, articles, discussion scenarios, local resources and more.     

Please share these resources with anyone who may need support. Thank you for your partnership in helping our members stay healthy.

1Derived from: Centers for Disease Control and Prevention, National Center for Health Statistics, Mortality 2018-2021 & Provisional Mortality 2022-2023 on CDC WONDER Online Database. Final data are from the Multiple Cause of Death Files 2018-2021 & from provisional data for years 2022-2023 as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at CDC Wonder: About Multiple Cause of Death, 2018-2021, Single Race & CDC Wonder: Provisional Mortality Statistics, 2018-Last Week in Feb, 2024. “Drug poisoning (overdose)” deaths reported here exclude suicide (X60-X64).

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Multnomah County Public Health Alert: Measles Outbreak in Oregon

According to a Multnomah County Public Health Clinician Alert, three cases of measles in two different households have been identified in June 2024. Two cases of measles have been identified in a Clackamas County household. They were believed to have been exposed in Marion County between May 19 and June 4, 2024. The primary affected individual, an unvaccinated adult, was confirmed to have measles June 14. They developed a rash June 11. The location of exposure is currently unknown, which suggests there may be other unrecognized cases in Oregon. The second household member, an unvaccinated child, developed symptoms a few days later. Both individuals are recovering.

A third case of measles in Marion County is confirmed in a 4 year old child. This child also developed a rash on June 11, and may have been exposed in the same time frame.

We request that area clinicians:

  • Keep measles on the differential for patients who present with compatible symptoms, especially if they report an exposure and/or are unvaccinated for measles.
  • Immediately notify your infection prevention team and the local public health authority (health department) where the patient lives if you suspect measles. See 24-hour contact information under the Resources section below.
  • Encourage vaccination in individuals 12 months and older who have not started or completed measles vaccination. See full vaccination recommendations, including contraindications such as pregnancy.
  • Distribute this notification to clinicians in your organization and networks.

Public Health is working with the cases to identify and monitor close contacts. Exposures may have occurred during the cases’ evaluation and treatment. However, the healthcare facilities and the cases did take appropriate available precautions, so these exposures are likely low risk. People might have been exposed if they were in any of these areas during these times:

  • OHSU facilities
    • Richmond Clinic’s Urgent Care area – Wednesday, June 12, 4:40–5:40 p.m.
    • OHSU Emergency Department (adult area): Wednesday, June 12, 6:00 p.m. – Friday, June 14, 7:15 p.m. (Risk here is believed to be low, as patient was masked and airborne precautions were implemented promptly)
    • ED Imaging – June 12 around 6:25 p.m., again around 7:20 p.m., and the following day June 13 around 12:15 p.m.

Resources

Public information about the measles can be viewed and shared on the Multnomah County Health Department webpage.

Patients or clinicians may call their respective Local Public Health Authority’s Communicable Disease team if they would like to talk through their situation and get recommendations for next steps. Suspected measles cases may also be reported 24 hours a day via these same channels.

Clackamas County Health Department: Communicable Disease team 503-655-8411

Marion County Public Health Division: Communicable Disease team 503-588-5621

Multnomah County Health Department: Communicable Disease team 503-988-3406

Washington County Health Department: Communicable Disease team 503-846-3594

View the full Multnomah County Public Health Clinician Alert

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