S5001 Insurance Policy Changes

[Ohio] Requirements for Including National Drug Code

Ohio Medicaid now requires National Drug Codes (NDC) to be included in the LIN segment of 837 claims for specific HCPCS and CPT drug codes (B4164-B4240, J0120-J9999, Q0138-Q9999, S0145-S5001, CPT 90281-90399). Notably, Q4100-Q4499 skin substitutes and RSV vaccine codes 90380-90381 are EXCLUDED from NDC requirements. The CTP segment must also be used for J-series, B-series, Q-series, and S-series drug codes.