MedicaidBilling CodesHigh impact
Newsletter Vol. 16, No. 21
New Jersey Medicaid·NJ·Pharmacy
Effective date
Apr 2, 2007
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid (NJFC) now requires reporting of the National Drug Code (NDC) alongside HCPCS procedure codes for all physician-administered drug claims submitted on CMS 1500 paper forms (rev. 0805) or HIPAA 837P electronic claims. Claims without the NDC will be denied. This change is effective April 2, 2007, and applies to all physician-administered drugs (HCPCS J0000-J9999 and Q0000-Q9999 codes).
Action Required
By April 1, 2007: Billing team must immediately transition to the new CMS 1500 paper claim form (rev. 0805) for all physician-administered drug claims. Update billing software to capture and require the 11-digit National Drug Code (NDC) from the drug manufacturer label for all claims submitted on or after April 2, 2007. For electronic claims (837P), ensure NDC is populated in Loop 2410 Field LIN03 per the HIPAA national standard. Contact software vendors to confirm NDC reporting capability is enabled. Train all billing staff and providers that claims submitted without the NDC for physician-administered drugs will be automatically denied by the state fiscal agent (Unisys). Download the revised HIPAA Companion Guide from www.njmmis.com in January 2007. Contact Unisys provider services (1-800-776-6334) with any questions.