Will Medi-Cal require a catalog page or invoice on the billings to determine pricing for insulin syringes?
No. Effective for dates of service on or after October 1, 2009, insulin syringes must be billed by pharmacy providers on the Pharmacy Claim Form (30-1), electronically in the NCPDP 1.1 batch transaction format, electronically in the NCPDP 5.1 format or the RTIP claim submission system with an established MAPC of $0.1800. Insulin syringes can no longer be billed using HCPCS Level II code S8490 so catalog page or invoices as attachments to the claims are no longer required.. • When submitting a claim on or after April 1, 2009 with date of service prior to April 1, 2009, what billing format should be used? A: The correct billing format is the NCPDP 1.1 batch format or the Pharmacy Claim Form (30-1) using the local “99” billing codes. Durable Medical Equipment (DME) providers will continue to bill using the CMS-1500 claim form or the ASC X12N 837P 4010A1 electronic format. • How will claim adjustments and reversals for services rendered prior to April 1, 2009 be handled if the transaction
Related Questions
- Should a high school student be allowed to keep her blood glucose supplies as well as insulin syringes in her locker at school?
- Does STORE facilitate the printing and mailing of invoices to those tenants that require a monthly invoice?
- Are shipping, mailing and/or postage included in the pricing on the Online Catalog order page?
