MedicaidAdministrativeMedium impact
BT202154: IHCP informs pharmacy providers of the billing specifications for prescription origin codes
Indiana Medicaid (IHCP)·IN · Family Medicine, Internal Medicine, General Practice +1 more·Pharmacy
We identified it
Jun 19, 2026
Summary
Indiana Medicaid is reminding pharmacy providers to accurately submit prescription origin codes (POC) in field 419-DJ when billing for prescriptions. The policy emphasizes proper use of codes 0-5 to indicate how prescriptions were received (written, electronic, fax, etc.) and warns that incorrect POC submissions are subject to audit and recovery.
Action Required
Immediately: Pharmacy billing staff must ensure accurate completion of prescription origin code field (419-DJ) for all Indiana Medicaid pharmacy claims. Use code 1 for written prescriptions, 2 for telephone, 3 for electronic, 4 for fax, and 5 for pharmacy transfers. Only use code 0 (not known) in rare circumstances. Review current billing practices to ensure compliance as incorrect POC codes are subject to audit and recovery.