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Molina Healthcare Posts Notice for DME Providers on Claims Issue


The Provider Relations Team at Molina Healthcare shared the following message with OAMES on 2/20/19 and asked that it be circulated to the HME provider community.

Molina Healthcare identified an issue on claims billed with codes B4220, B4222 and B4224 denying for missing National Drug Code (NDC) when NDC is not required.

Codes B4220, B4222 and B4224 were set to require an NDC code as Molina misinterpreted the list provided by ODM with open end dates as requiring NDC. These codes have been removed from Molina’s crosswalk to require NDC with an effective date of Nov. 11, 2017.

Claims impacted are being sent to be adjusted and paid without NDC codes. Claims will be adjusted by March 15, 2019.  If you have questions, please call Molina Provider Services at (855) 322- 4079.

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