MedicaidAdministrativeMedium impact
Attention Providers Billing for Physician-Administered Drugs (PAD): System Updates
Nevada Medicaid·NV·Billing & Coding
Effective date
Apr 21, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has implemented system updates for physician-administered drug (PAD) billing that may cause claim denials with 'HCPCS/NDC Combination Not Valid' error messages due to a delay in First Databank file upload. This particularly affects unclassified HCPCS codes on professional medical claims.
Action Required
Immediately: Nevada providers billing physician-administered drugs should monitor claims for 'HCPCS/NDC Combination Not Valid' denial messages, particularly for unclassified HCPCS codes. Billing team should prepare to resubmit affected claims once system updates are complete and verify NDC-HCPCS combinations before submission.