July 31, 2017
Beginning August 15, VDP will enhance the restriction on the use of products containing tramadol and codeine for people enrolled in Medicaid fee-for-service. The new restriction will be based on the information found on the April 20, 2017, Food and Drug Administration Drug Safety Communication about the use of prescription codeine pain and cough medicines and tramadol pain medicines in children.
Products containing tramadol and codeine will no longer be available for children younger than 12. Medicaid fee-for-service claims will deny with NCPDP error code 60 and include the message “Not Covered For Under Years Of Age” in the “Additional Message Information” field (526-FQ). These products also won’t be allowed in a multi-ingredient compound claim for this population.
This change is optional for managed care organizations.