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Related post: will be accepted for issuing service authorizations and/or DVS prior authorizations. (�C - capture (field 112-AN) and NO CLAIM TO FA� (field 503-F3) will be 3, 5 or 6 Greater than 51 ECCA The transaction will be rejected. or NCPDP Reject Code 13 M/I Other Coverage Code and Response Code 716 Other Payor Amount Must Be Equal to 0 will Buy Metoprolol Online be returned. Chart 2 - Recipient without Coverage Codes on file Rev. (04/05) Field 308-C8 Field 431-Field 104-A4 Value DV Value Value 2 or 8 Not sent 51 Non-ECCA If all other edits are passed, the transaction will be accepted for issuing service authorizations and/or DVS prior authorizations. (�C - capture (field 112-AN) and NO CLAIM TO FA� (field 503-F3) will be 2 or 8 Not sent 51 ECCA If all other edits are passed, the claim will be approved for payment. (�C - capture (field 112-AN) and spaces will be returned in (field 0, 1 or 7 Not sent 51 ECCA If all other edits are passed, the claim will be approved for payment. (�C - capture (field 112-AN) and spaces will be returned in (field 0, 1 or 7 Not sent 51 Non-ECCA If all other edits are passed, the transaction will be accepted for issuing service authorizations and/or DVS prior authorizations. (�C - capture (field 112-AN) and NO CLAIM TO FA� (field 503-F3) will be 0, 1, 3, 5, 6 Zeros 51 Non-ECCA If all other edits are passed, the transaction or 7 will be Order Metoprolol Online accepted for issuing Metoprolol Online service authorizations and/or DVS prior authorizations. (�C - capture (field 112-AN) and NO CLAIM TO FA� (field 503-F3) will be 0, 1 or 7 Zeros 51 ECCA If all other edits are passed, the claim will be approved for payment. (C - capture (field 112-AN) and spaces will be returned in (field 3, 5 or 6 Zeros, Purchase Metoprolol blank 51 ECCA If all other edits are passed, the claim will be or not sent approved for payment. (�C - capture (field 112-AN) and spaces will be returned in (field July 2010 2.10.5 Unique Treatment of Fields Field 308-C8 Field 431-Field 104-A4 Value DV Value Value 3, 5 or 6 Not sent 51 Non-ECCA If all other edits are passed, the transaction will be accepted for issuing service authorizations and/or DVS prior authorizations. (�C - capture (field 112-AN) and NO CLAIM TO FA� (field 503-F3) will be 0, 1, 3, 5, 6 Greater than 51 ECCA The transaction will be rejected. Non-ECCA NCPDP Reject Code DV - M/I Other Payor Amount Paid and Response Code 320 - Other Insurance Information Inconsistent� will 4 Greater than 51 Non-ECCA 4 Not sent or 51 Non-ECCA If all other edits are passed, the transaction zeros will be accepted for issuing service authorizations and/or DVS prior authorizations. (�C - capture (field 112-AN) and NO CLAIM TO FA� (field 503-F3) will be 2 or 8 Greater than 51 Non-ECCA If all other edits are passed, the transaction Zero will be accepted for issuing service authorizations and/or DVS prior authorizations. (�C - capture (field 112-AN) and NO CLAIM TO FA� (field Metoprolol Buy 503-F3) will be 2 or 8 Greater than 51 ECCA If all other edits are passed, the transaction Zero will be accepted for payment. (�C - capture (field 112-AN) and spaces will be returned in 2 or 8 Zeros 51 Non-ECCA The claim will reject. NCPDP Reject Code or �13 M/I Other Coverage Code and Response Code 715 Other Payor Amount Must Be Greater Than 0 will be returned. Eligibility Clarification Code - (Insurance Segment) Field 309-C9 This field is used to submit overrides for Excess Income/Spenddown or Nursing Home This field will be used in conjunction Buy Cheap Metoprolol with Field 433-DX, Patient Paid Amount (Pricing Segment), to allow pharmacies to have Purchase Metoprolol Online their claims electronically captured and adjudicated for Excess Income/Spenddown recipients. This field is used when the recipient�s eligibility has not yet been updated on file at the eMedNY contractor. Only recognized entry is: 2 = Override (replaces SA Exception Code 4 - Temporary Medicaid Authorization/Excess Income - Spenddown) or Nursing Home Override July 2010 2.10.6 Unique Treatment of Fields Note: The eMedNY will allow all NCPDP identified values (0 through 6). However, 2� is the only value utilized by the NYS Medicaid. If field 309-C9 contains a value of 2� (to override Excess Income/ Spenddown) Field 433- DX must contain zeros or a dollar amount. Field 433-DX should only contain zeros when the recipient has already met their spenddown but eligibility has not yet Generic Metoprolol been updated on the file at the eMedNY contractor. In all other cases, Field 433-DX should contain the dollar amount incurred or paid to the pharmacy by the recipient. Excess Income claims will bypass eligibility editing but will be processed through the DUR edits. If the claim passes all edits, the recipient�s DUR drug profile will be updated and the entry Buy Metoprolol in Field 433-DX will be included in the Other Insurance Paid field on your remittance Note: An approved Excess Income override claim will pend for thirty days waiting for the eligibility update to occur. The online response will be Table 10 response code 317 (Claim Pending: Excess Income/Spenddown). If the necessary update does not occur within the thirty-day period, your claim will be denied. More information on Table 10 Pend Response codes can be found under the Additional Message Field 526-FQ in this section. The Eligibility Clarification Code (309-C9) field may also be used to report a Nursing Home Override in those instances where the Client�s file shows residency within an In- State Skilled Nursing Facility that covers pharmacy services. The override procedure may be used to resubmit a previously denied claim. If the Client has been discharged but the eMedNY Contractors file shows that the Client still resides in the Skilled Nursing Facility, you Order Metoprolol may submit an override. This will result in a pend status which will give the local districts time to update the Client�s file. If the update is not received within 30 days, the Compound Code - (Claim Segment) Field 406-D6 This is a one (1) position field and will be used to alert the system as to the type of editing to perform. The allowable values are: 0 = Should be entered when dispensing any five (5) character alpha numeric Product Supply Code from sections 4.2 and 4.3 in the MMIS Pharmacy Provider Manual. Claim can be captured for adjudication and will be considered as one unit for UT and P & C. No DUR processing will occur. This value should also be used for DVS 1 = Should be entered when dispensing a prescription with an NDC code. Claim can be captured for adjudication and all processing will occur. May also be entered when dispensing a Product Supply Code as described above. 2 = Should be entered when dispensing a compound drug code. Claim will be considered as one unit for UT and P & C. No DUR processing will occur. Prior Auth Type Code - (Claim Segment) Field 461-EU This field is a two (2) position numeric field. There are three possible values for this field: July 2010 2.10.7 Unique Treatment of Fields 00 = Not specified 01 = Prior Authorization/Prior Approval. If this value is used, field 462-EV must contain the prior approval number.
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