837 Health Care Claim: Institutional - Louisiana Medicaid
837 Health Care Claim: Institutional - Louisiana Medicaid
837 Health Care Claim: Institutional - Louisiana Medicaid
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06/30/2014 <strong>Health</strong> <strong>Care</strong> <strong>Claim</strong>: <strong>Institutional</strong> - <strong>837</strong>LINLA MEDICAID:Drug IdentificationPos: 4930 Max: 1Detail - OptionalLoop: 2410 Elements: 2A federal statute mandates that providers must report National Drug Code (NDC) information for allphysician-administered drugs on LA <strong>Medicaid</strong> claims submissions. This requirement applies to both electronic andhard copy claims. Providers are required to submit NDC information for the corresponding HCPCS code forphysician-administered drugs. <strong>Claim</strong>s must reflect the NDC from the label of the product administered.<strong>Louisiana</strong> <strong>Medicaid</strong> also requires DME providers to report NDC information associated with HCPCS codes on claimssubmitted for enteral therapy products. This requirement also applies to pharmacies that dispense DME supplies to<strong>Medicaid</strong> recipients.Element Summary:RefLIN02Id235Element NameProduct/Service ID QualifierReqMTypeIDMin/Max2/2LA <strong>Medicaid</strong>: Use the value N4 for this elementLIN03 234 Product/Service ID M AN 1/48User Option (Usage): SituationalLA <strong>Medicaid</strong>: Enter the National Drug Code associated with thephysician-administered drug identified as the service in Loop2400 SV202-02.19
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