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Multi-Ingredient Compound Submission Procedures

Place Client Logo here. Multi-Ingredient Compound Submission Procedures. Submitting Multi-Ingredient Compounds. All compounds must be submitted using the Multi-Ingredient compound template Contact your software provider if unsure how to submit a Multi-Ingredient compound template

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Multi-Ingredient Compound Submission Procedures

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  1. Place Client Logo here Multi-Ingredient Compound Submission Procedures

  2. Submitting Multi-Ingredient Compounds All compounds must be submitted using the Multi-Ingredient compound template Contact your software provider if unsure how to submit a Multi-Ingredient compound template SC Medicaid Bulletin

  3. Submission Procedure for Compound Claims • There are three areas to complete when filing a compound claim • Claim Segment • Compound Segment • Each line item

  4. On Claim Segment SUBMISSION CLARIFICATION CODE (NCPDP field # 42Ø-DK) = 8. PRODUCT/SERVICE ID QUALIFIER (NCPDP field # 436-E1) = 03. PRODUCT CODE/NDC (NCPDP field # 4Ø7-D7) Enter as 00000000000 COMPOUND CODE (NCPDP field # 4Ø6-D6) = 2. QUANTITY DISPENSED (NCPDP field # 442-E7) for entire product. GROSS AMOUNT DUE (NCPDP field # 43Ø-DU) for entire product.

  5. On Compound Segment COMPOUND DOSAGE FORM DESCRIPTION CODE (NCPDP field # 45Ø-EF) COMPOUND DISPENSING UNIT FORM INDICATOR (NCPDP field # 451-EG) COMPOUND ROUTE OF ADMINISTRATION (NCPDP field # 452-EH) COMPOUND INGREDIENT COMPONENT COUNT (NCPDP field # 447-EC) (Maximum of 25 ingredients) (See next slide for valid entries for compound segments)

  6. Valid Entries for Dosage, Unit, and Route

  7. For Each Line Item COMPOUND PRODUCT ID QUALIFIER (NCPDP field # 488-RE) COMPOUND PRODUCT ID (NCPDP field # 489-TE); (i.e., NDC of each ingredient) COMPOUND INGREDIENT QUANTITY (NCPDP field # 448-ED); (i.e., quantity of each ingredient) COMPOUND INGREDIENT DRUG COST (NCPDP field # 449-EE); (i.e., ingredient cost of each ingredient)

  8. Reminder Contact your Software Provider if you are unsure where fields are located

  9. Important Notes The claim segment product ID (i.e., NDC) is a mandatory field when submitting multi- ingredient compound claims A multi-ingredient compound claim must be submitted with eleven zeroes (00000000000) A claim will reject if all zeroes are not submitted as the product ID

  10. Contacts SC • Magellan Medicaid Administration • SCProvidersupport@magellanhealth.com • SCDHHS • Janet Giles • Gilesje@scdhhs.gov • Brandie Crider • CRIDERB@scdhhs.gov • Phone: 803-898-2876

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