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New Jersey MedicaidMedicaid · Billing Codes · Pharmacy · NJHigh impact

Newsletter Vol. 19, No. 18

Act
by Jun 8, 2009
Effective date
Jun 8, 2009
Identified
Jun 20, 2026

Summary

New Jersey Medicaid/NJ FamilyCare changed payment procedures for physician-administered prescription drugs, requiring all claims to be priced using the State's Master Drug File instead of previous reimbursement methods. Claims must include specific NDC numbers, quantities, and unit of measure qualifiers in proper format.

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What to do

by Jun 8, 2009 · 4 steps
01Billing team must update all physician-administered drug claims to include proper NDC formatting in Field 24A with 'N4' qualifier, 11-digit NDC number, three spaces, two-position unit of measure qualifier (F2, GR, ML, or UN), and quantity.
02Use www.njmmis.com website to verify correct unit of measure for each NDC.
03For J3490, J3590, and J9999 codes, submit original hard-copy claims to Unisys.
04Claims without proper NDC formatting will be denied with specific error codes.

Codes mentioned

J0120J1000J2000J3000J3490J3590J4000J5000J6000J7000J8000J9000J9999Q0144Q0145Q0150Q0160Q0170Q0180Q0181Q4079Q4080Q4081Q9945Q9950Q9960Q9970Q9980Q9990Q9999Q3025Q3026Q2009Q2017

Original notice

Newsletter Vol. 19, No. 18
njmmis.com · Always check the source before changing claims.
View original ↗

Related changes

See all New Jersey Medicaid changes →
Newsletter Vol. 17, No. 05HighEffective Apr 1, 2007 · CodingNewsletter Vol. 17, No. 13HighEffective Aug 6, 2007 · CodingNewsletter Vol. 32, No.07HighNo effective date · Provider NoticeNewsletter Vol. 19, No. 50HighEffective Nov 1, 2009 · CodingBrowse every New Jersey Medicaid change in the policy list

Related policy hubs

New Jersey Medicaid policiesNJ policy changesCode J0120Code J1000Code J2000Code J3000Code J3490Code J3590Code J4000Code J5000Code J6000Code J7000Code J8000Code J9000Code J9999Code Q0144Code Q0145Code Q0150Code Q0160Code Q0170Code Q0180Code Q0181Code Q4079Code Q4080Code Q4081Code Q9945Code Q9950Code Q9960Code Q9970Code Q9980Code Q9990Code Q9999Code Q3025Code Q3026Code Q2009Code Q2017

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