Wiki Medicaid Claims and NDC's !!!!!

[DWILHELM]

As I'm sure lots of you would agree, Medicaid is pretty inconsistent with processing those HCPCS that require the NDC on the claim. I guess I just would like to hear how a few others are submitting these when billing out to Medicaid. Specificially, codes J0152, J2785 and J1250.

What exactly is your narrative on the claim for the NDC? What about a Title XVIII?

Thanks so much!

 

[jreavis]

Check your Medicaid website. North Carolina wants very specific info in the narrative field. Example, electronically they want the NDC number 3 blank spaces then ML and how many MLs. If paper, they want N4 followed immediately by the NDC # then 3 blank spaces and ML and how many MLs.

 

[DWILHELM]

Thanks jreavis - I do bill according to Virginia Medicaid guidelines on this, but they inevitably deny a majority of them to "missing/invalid NDC" - I really feel it's Medicaid dragging their feet so I was just wondering about an effective way to address/appeal this after, let's say, the third denial.

I appreciate you responding - if you've ever had to appeal after several denials and you know you were compliant with their way in which to file it, let me know what worked

Thanks