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Miriam,
Supposedly the state of Indiana has decided to require the NDC so that they could collect rebate dollars
for drugs being billed. I found out about the
"Indiana requirement" last week and it appears that Illinois Medicaid also has
NDC requirements. I have called/e-mailed Indiana EDS for a definitive
source for the NDC requirement for the 837 transactions because their draft
companion guides still list the 2410 segments as situational, but am not
receiving any response. Do you have a formal document that lists the
requirement?
I have also asked EDS how/where they expect to see
this data on hard copy claims should that be necessary.
Marcus E. McCrory
The Cirius Group,
Inc.
(925) 685-9300 (tel)
(925) 685-6526 (fax)
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----- Original Message -----
Sent: Friday, August 08, 2003 9:39
AM
Subject: RE: NDC Codes - Medicare vs.
Medicaid
Miriam, I have not heard of a similar requirement for Alabama Medicaid.
The state has converted local codes to use J codes. The way I
understand the implementation guide is that NDC is only used "when
required by government regulation" or "as deemed appropriate by the provider
to enhance reporting/adjudication processes". So, IMO, unless Indiana or
any other state has a regulation to require use of the NDC, the facility
should not have to report NDC unless it chooses to.
John
Craft
Partner, HCS
866-271-1359
In
a recent provider workshop conducted in Indiana by AdminaStar Federal
(Medicare FI), the following issue came up.
The representative for AdminaStar
Federal confirmed that Medicare will not require NDC codes
for drugs (i.e., "J" codes will work). She went on to say that
Medicaid, however, says it will require NDC
codes. Members
of the hospital's billing
staff were told at a Medicaid
workshop (held during the week before) that because
the new claim field isn't big enough to contain the entire NDC code, the
last couple of digits of the NDC code should be placed in another
field. A related question involves how "cross over" claims will be
handled between Medicare and Medicaid when NDC codes are
involved.
Are the rest of you
running into this in other
states?
Best
Regards,
Miriam J. Paramore
President & CEO
Co-Founder and President
PCI: e-commerce for healthcare
HAWK - HIPAA Action Workgroup of Kentucky
9001 Shelbyville
Road
www.hawkonline.org
iTRC Building
Louisville, KY 40222
ph
502-429-8555 fax
502-852-4701
www.hipaasurvival.com
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