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Back  RFI # 592: Drug code missing or invalid

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Submitter

Allen Carol

Description

HIR 366 recommends default codes for medical, dental and hospital in order to satisfy SVC01 requirement. Is there a default code that could be recommended for Pharmacy Claims ?

Response

There is not a default NDC that can be recommended for usage in this situation. The workgroup recommends following the same processes for a paper claim as with an electronic claim, specifically, reject the claim back to the submitter.

Recommendation

Submission 8/15/2007
Status Date 7/9/2008
Status F - Final
Primary References
Document 005010X221
Section2.4
Page188
Set IDSVC01
Table2
Loop2110
Segment Position0700
Segment IDSVC
Element Position01
Component Position2
Industry NameAdjudicated Procedure Code