AFFECTED CPTs – J7613, J7626,J2405, J0696
DESCRIPTION OF THE ISSUE
Medicaid and MCD HMOs denied all injection codes for need of NDC# update.
CONCEPT
All injection drug codes should be billed along with NDC# updates for the claims to be reimbursed.
REASON
Compiled list of injection codes that were denied for NDC# update towards Dr’s office, for which we received NDC# information from the provider. Later we refiled all denied claims with NDC#. But the still the claims got denied for invalid/missing NDC#. Hence we analyzes on the NDC# update is still going on.
