Wiki Medicaid flu shot denial

[kcarlyle]

Medicaid NC denied flu shot 90688 due to "the drug class of the tenth submitted NDC must match the drug class of the submitted HCPCS drug code." Do you know what this means? The NDC billed is NDC Package Code: 19515-0903-11 and is billed with ML0.5, 1 unit. Should the NDC code on the bottle 19515-0903-01 be billed instead?

 

[Cynthia Hughes]

Vaccine NDC

Medicaid NC denied flu shot 90688 due to "the drug class of the tenth submitted NDC must match the drug class of the submitted HCPCS drug code." Do you know what this means? The NDC billed is NDC Package Code: 19515-0903-11 and is billed with ML0.5, 1 unit. Should the NDC code on the bottle 19515-0903-01 be billed instead?

I am not in NC but came across this recently.
https://www.nctracks.nc.gov/content/public/providers/faq-main-page/faqs-for-claim-submission.html Question 2 asks if NDC should be reported for vaccine and answer is no.

 

[kcarlyle]

Thanks!