Or. Admin. Code § 410-121-0200

Current through Register Vol. 63, No. 11, November 1, 2024

Section 410-121-0200 - Billing Forms

Guidelines for using the Prescription Drug Invoice 1.2 Universal Claim Form.

(1) When a paper claim form is needed, this form is used to bill for all pharmacy services, home blood glucose monitors, and related diabetic supplies. These services must be billed with a National Drug Code (NDC).

(2) The provider may bill on the form when a valid Medical Care Identification has been presented (Refer to OAR 410-120-1140 Verification of Eligibility).

(3) All completed 1.2 Universal Claim Forms must be mailed to the Health Systems Division (Division).

(4) All other durable medical equipment and certain Enteral/Parenteral Nutrition and IV Services must be billed on the CMS-1500, using the billing instructions found in the Division's Durable Medical Equipment and Medical Supplies administrative rules (division 122) and Supplemental Information, and the Division's Home Enteral/Parenteral Nutrition and IV Services Administrative rules (division 148) and Supplemental Information. These services are billed with HCPCS procedure codes.

Or. Admin. Code § 410-121-0200

HR 29-1990, f. 8-31-90, cert. ef. 9-1-90; HR 20-1994, f. 4-29-94, cert. ef. 5-1-94; OMAP 20-2003, f. 3-26-03, cert. ef. 4-1-03; OMAP 40-2003, f. 5-27-03, cert. ef. 6-1-03; OMAP 18-2004, f. 3-15-04 cert. ef. 4-1-04; DMAP 34-2008, f. 11-26-08, cert. ef. 12-1-08; DMAP 14-2011, f. 6-29-11, cert. ef. 7-1-11; DMAP 11-2018, amend filed 03/02/2018, effective 3/2/2018

Publications referenced are available from the agency.

Statutory/Other Authority: ORS 413.042 & 414.065

Statutes/Other Implemented: ORS 414.065