Medicaid revenue code 636 and 250

kyeltonkyelton
in BILLING AND CLAIMS

We are currently billing Medicaid claims related to drugs with Revenue code 636.  As our understanding is we have to use 636, HCPCS code, and NDC number. 

I.e.-The NDC number we used for Lidocaine is non-rebateable for Medicaid.  I understand with Lidocaine, yes it can be packaged within the surgery.  However, Lidocaine  can also be given without a surgical procedure.

We bill under revenue code 636, with HCPCS, and NDC #... We get denied as non-rebateable.

If we take the HCPCS and NDC # off and bill under revenue code 250… We get paid.

There has been concern if that is the appropriate thing to do.

Is anyone billing with revenue code 250 and receiving payment?  If so, how are you able to use 250 and not report 636 since you have a NDC number?

Thanks


Comments

  • trositrosi
    What State are you in?  Seems like maybe this could vary from State to State.
Sign In to comment.