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New Jersey MedicaidMedicaid · Administrative · Pharmacy · NJ · PharmacyMedium impact

Newsletter Vol. 13, No. 17

Act
by Jun 15, 2003 (first testing window)
Effective date
Apr 1, 2003
Identified
Jun 20, 2026

Summary

New Jersey is implementing NCPDP version 5.1 (point-of-sale) and version 1.1 (batch) electronic claim formats for pharmacy claims. Providers must test their practice management systems during designated testing windows using the new format specifications, including changes to packaging/units procedures, coordination of benefits fields, and compound drug claim reporting.

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What to do

by Jun 15, 2003 (first testing window) · 7 steps
01Pharmacy providers and software vendors must register with Lorraine.Harris@dhs.state.nj.us to participate in POS testing.
02Update practice management systems to generate claims in NCPDP version 5.1 format with 'NJT' in the Submitter Field (instead of 'NJP').
03Test claims must use recent past dates of service and active beneficiary ID numbers.
04Do NOT contact First Health Services for prior authorization on test claims.
05Screen print test results for records before deletion by Unisys.
06For batch format (NCPDP version 1.1), submit CD with no more than 5 test claims to Lorraine Harris at the Trenton address.
07Contact (609) 588-6291 for technical questions or (609) 588-2724 for policy questions.
If missed: Failure to test and implement the new format may result in claim submission errors when mandatory conversion occurs.

Original notice

Newsletter Vol. 13, No. 17
njmmis.com · Always check the source before changing claims.
View original ↗

Related changes

See all New Jersey Medicaid changes →
Newsletter Vol. 13, No. 01LowEffective Jan 1, 2003 · Provider NoticeNewsletter Vol. 13, No. 02MediumEffective Jan 1, 2003 · CodingNewsletter Vol. 13, No. 03MediumNo effective date · Provider NoticeNewsletter Vol. 13, No. 04LowEffective Dec 27, 2002 · PharmacyBrowse every New Jersey Medicaid change in the policy list

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