Prescribed Drugs Provider Manual - Iowa Department of Human ...
Prescribed Drugs Provider Manual - Iowa Department of Human ...
Prescribed Drugs Provider Manual - Iowa Department of Human ...
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<strong>Iowa</strong><strong>Department</strong><strong>of</strong> <strong>Human</strong>Services<strong>Provider</strong> and Chapter<strong>Prescribed</strong> <strong>Drugs</strong>Chapter III. <strong>Provider</strong>-Specific PoliciesPage125DateAugust 1, 2013Field NameField DescriptionU Gynecology feeV Obstetrics feeW Child feeX Medicare or coinsurance deductiblesY Immunization replacementZ Batch bill APG0 APG1 No payment APG3 HMO/PHP rate4 System parameter rate5 Statewide per diem6 DRG auth or new7 Inlier/outlier adjust8 DRG ADR inlier9 DRG ADR13 EOB Explanation <strong>of</strong> benefits (EOB) code, if denied. Adescription <strong>of</strong> the code can be found on thesummary page <strong>of</strong> the Remittance Advice (Field O).14 Practitioner Name <strong>of</strong> prescribing provider15 Drug Name Name and dosage <strong>of</strong> drug dispensed16 Adj-R Reason code indicating the reason for theadjustment17 TCN-to-Credit 17-digit TCN number <strong>of</strong> the claim being credited
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