MedicaidAdministrativeMedium impact
Senior Services News Vol. 8, No. 03
New Jersey Medicaid·NJ·Pharmacy
Effective date
May 1, 2004
We identified it
Jun 20, 2026
Summary
New Jersey PAAD program now requires pharmacies to bill other insurance carriers first before submitting claims to PAAD, and to report all payments from other insurers using specific NCPDP fields and Other Coverage Codes.
Action Required
By May 1, 2004: Pharmacy billing teams must update workflows to bill primary insurance carriers before submitting PAAD claims. Configure systems to use NCPDP field #431-DV for Other Payer Amount Paid and appropriate Other Coverage Codes (#308-C8). Update MC-6 claim forms to include TPL payment amounts. Contact Unisys Provider Services at 1-800-776-6334 for MC-6 forms. Claims without proper third-party liability reporting will be denied.