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National Drug Code (NDC) Rejections for Flu Vaccine on Medicaid Claims

Posted November 3, 2017

Blue Cross and Blue Shield of Illinois (BCBSIL) has identified an issue that has impacted the processing and payment of claims submitted for Blue Cross Community MMAI (Medicare-Medicaid Plan)SM, Blue Cross Community Integrated Care Plan (ICP)SM, Blue Cross Community Family Health PlanSM (FHP) and Blue Cross Community Managed Long Term Supports and ServicesSM (MLTSS) members.

Beginning in August 2017, Medicaid claims submitted with Current Procedural Terminology (CPT®) code 90686, containing Fluarix Quad 2017-2018 Syringe: NDC 58160090741, may have been rejected for invalid NDC. BCBSIL has rectified the issue by adding this flu vaccine NDC as a valid code available for use.

As of Nov. 1, 2017, providers who received rejections for the above issue can now resubmit as new claims.

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