Client Version Audit Code to IN Admin Code Approved 061509

INFSSAInformation For Final Determination LettersAudit Where To Look For More What Was Found What Went Wrong How To Fix It Citation of Administrative CodeCode InformationINDIANA HEALTH COVERAGE PROGRAMS PROVIDER MANUAL: Chapter 9: Pharmacy Pharmacy has the option to submit Services:Libraray Reference The prescription was written as a an Indiana Medicaid Compound Number PRPR10004 (Revision TITLE 405 OFFICE OF THE SECRETARY OF FAMILY AND Claim should be billed as a compound however, the Drug Claim Form to Prudent Rx. All Date March 2009 Version 8.1)CC SOCIAL SERVICES 405 IAC 1-5-1 Medical records; compound pharmacy did not bill it as a refills should be corrected and contents and retentioncompound. billed with the appropriate The Medicaid Compound Drug compound claim indicator. Claim Form, as well as detailed billing instructions, can also be found on the IHCP Web site at www.indianamedicaid.com.Excluded from recovery per client No further action is required by the CE N/A N/A N/Arequest pharmacy.The pharmacy indicates that there No further action is required by the Claim does not belong to is no record of the prescription CL pharmacy; the claim will be N/A N/Apharmacy and/or patient in their computer recouped.system.No further action is required by the CN Audit cancelled N/A N/A N/Apharmacy.TITLE 21 - FOOD AND DRUGSCHAPTER 13 - DRUG ABUSE TITLE 21 - FOOD AND DRUGSPREVENTION AND CONTROL CHAPTER 13 - DRUG ABUSE PREVENTION AND SUBCHAPTER I ...