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MedicaidAdministrativeHigh impact

Medicaid Alert - MA2011-01

New Jersey Medicaid·NJ·Provider Notice
Effective date
Oct 11, 2011
We identified it
Jun 20, 2026
Days to comply

Summary

New Jersey Medicaid now requires pharmacy providers to include the exact amount paid by other insurers in the Coordination of Benefits segment for all secondary claims. Claims missing this information will be denied with Error Code 2136 starting October 11, 2011.

Action Required

Action needed
By October 11, 2011: Pharmacy billing team must update billing software to include the 'Other Payer Amount Paid' field (431-DV) and appropriate qualifier (342-HC) for all secondary Medicaid claims. Enter $0.00 when no amount was paid by primary payer. Contact software vendor to implement changes. Claims will be denied with Error Code 2136 if this information is missing.