| General |
 | Updated “Drugs Requiring NDC for Texas Medicaid and CSHCN Services Program Reimbursement” List |
| Information posted May 8, 2009: Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program are expanding the list of procedure codes that will be denied if submitted without an 11-digit National Drug Code (NDC). Effective June 1, 2009, claims for the following additional procedure codes must be submitted with an 11-digit NDC: J9206, J2405, J1626, J9178, J3370, J1170, J9293, J9190, and J9062. If these procedure codes are submitted without NDC information, they will be denied, even if they have been prior authorized. Click on the title for more information. |
 | List of Top Physician-Administered Multiple-Source Drugs Now Available |
| Information posted February 13, 2009: The Texas Medicaid and Children with Special Health Care Needs (CSHCN) Services Program Top Physician-Administered Multiple-Source Drugs List is now available on the National Drug Code (NDC) page of this website. The Texas Medicaid and CSHCN Services Program Top Physician-Administered Multiple-Source Drugs list are those physician-administered, multiple-source drugs that the U.S. Secretary of Health and Human Services has determined to have the highest dollar volume of physician-administered drugs that are dispensed through Medicaid. Click on the title to view the list. |
| List of Top Physician-Administered Multiple-Source Drugs Now Available |
| Information posted February 13, 2009: The Texas Medicaid and Children with Special Health Care Needs (CSHCN) Services Program Top Physician-Administered Multiple-Source Drugs List is now available on the National Drug Code (NDC) page of this website. The Texas Medicaid and CSHCN Services Program Top Physician-Administered Multiple-Source Drugs list are those physician-administered, multiple-source drugs that the U.S. Secretary of Health and Human Services has determined to have the highest dollar volume of physician-administered drugs that are dispensed through Medicaid. Click on the title to view the details. |
| National Drug Code Data Claims Update |
| Information posted January 27, 2009: Effective January 30, 2009, claims submitted for professional, outpatient, and family planning services that include physician-administered prescription drug procedure codes will no longer require the National Drug Code (NDC) unit of quantity or the NDC unit of measurement codes. Click on the title to view the details.
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| Reminder to Include NDC Number on Palivizumab (Synagis) Claim Forms |
| Information posted October 24, 2008: The respiratory syncytial virus (RSV) season is quickly approaching, and providers are reminded that they must include the complete 11-digit National Drug Code (NDC) number when submitting claims for the administration of the palivizumab (Synagis) vaccine using procedure code 90378. If the NDC information is missing, claims submitted with procedure code 90378 will be denied even when they have been prior authorized. Click on the title to view details. |
| NDC-to-HCPCS Crosswalk Now Published by Noridian Administrative Services LLC |
| Information posted October 16, 2008: Effective August 18, 2008, the National Drug Code (NDC) to Healthcare Common Procedure Coding System (HCPCS) crosswalk is now published by Noridian Administrative Services LLC. Previously, the NDC-to-HCPCS crosswalk was published by Palmetto Government Benefits Administrator (GBA). Click on title to view the details.
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| National Drug Code Information Update |
| Information posted January 11, 2008: This is an update to a website article published on September 24, 2007, and a banner message published on the September 28, 2007, Remittance and Status (R&S) report about the National Drug Code implementation. Click on the title to view the details. |
| National Drug Code to Be Required for Medicaid, Family Planning, and CSHCN Services Program Provider |
| Information posted September 24, 2007: Effective for dates of service on or after January 1, 2008, all Medicaid fee-for-service, Primary Care Case Management (PCCM), Family Planning, and Children with Special Health Care Needs (CSHCN) Services Program providers that submit professional or outpatient claims with procedure codes in the J and Q code series (physician-administered prescription drugs) will be required to provide a National Drug Code (NDC). Drug claims submitted with procedure codes in the A code series will not require an NDC. Click on the title to view the details. |
| Entering National Drug Code Data |
| Information posted January 11, 2008: TMHP will require the use of National Drug Code (NDC) on claim forms effective January 1, 2008. This message is in response to providers seeking clarification from TMHP about the proper way to submit NDC data on claim forms. Click on the title to view the details. |
| NDC Reminder for All Providers |
| Information posted January 28, 2008: TMHP is reminding Medicaid fee-for-service, Primary Care Case Management (PCCM), Family Planning, and Children with Special Health Care Needs (CSHCN) Services Program providers that, as of January 1, 2008, all professional and outpatient claims with physician-administered prescription drug procedure codes that are currently listed on the Palmetto GBA “NDC to HCPCS Crosswalk” must be submitted using the appropriate associated National Drug Code (NDC) for payment consideration. If providers have submitted claims without the NDC and have received denials, providers may appeal their claims by adding the appropriate NDC code on their claim as outlined in the January/February 2008 Texas Medicaid Bulletin, No. 212, on page 10. For more information, please call the TMHP Contact Center at 1-800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 1-800-568-2413. |
| Revised Claim Form Information |
| CMS-1500 Claim Form |
| Information posted November 5, 2007: Update to CMS-1500 Boxes 24A, 24D, 24G
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| UB-04 Claim Form |
| Information posted November 5, 2007: Update to UB-04 Box 43 |
| Family Planning 2017 Claim Form |
| Information posted November 5, 2007: Update to FP2017 Boxes 32A, 2D, 32F |
| Provider Education |
 | Validate your File Structure with TMHP EDI Testing |
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| Register for a Workshop |
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