MMA is currently covering
compound claims. All compounds must be submitted using
the NCPDP version D.0 standard multi-ingredient
compound functionality. Therefore, all ingredients
must be identified, their units must be indicated, and
the ingredient cost for each ingredient must be
submitted on the claim.
At least one item in the
compound must be a covered drug. Any component of a
compound requiring PA will necessitate an approval
prior to receiving payment. For additional
information, refer to the Payer Specification
document on the Plan Portal.
Refer to the LA MCO
Compounding Claims Submission document
here
for more info.
