What Medicaid Information is in Find-A-Code?

Oct 31st, 2024

Medicaid is a government-sponsored health insurance program in the United States designed to provide free or low-cost healthcare to low-income individuals and families, as well as to certain groups such as the elderly, people with disabilities, and children. Medicaid is jointly funded by federal and state governments, and each state administers its own program which must, at a minimum, meet the federal requirements. Due to state-specific administration and regulations, there is some variation in coverage and eligibility criteria.

Note: Because of individual state requirements, it is recommended that healthcare organizations contact their state or professional associations for information that may be specific to their location and specialty.

Find-A-Code provides some Medicaid information to help our customers:

• NCCI Edits Validator Medicaid Edition: Compare codes using CMS’ NCCI Edits.
• Link to Medicaid.gov FAQs: Ask a specific question, or filter by a specific topic.
• Codes Sets:
  • ICD-10-CM Codes
  • CDPS Codes: Includes risk weights, Hierarchy precedence, additional code information, definitions and CDPS to ICD–10-CM crosswalks
  • CDPS+RX Codes: Includes the same information as CDPS, but adds a Pharmacy Component to the code
  • MRX Codes: Pharmacy-based system that uses National Drug Classification (NDC) codes to assign MRX Categories based on types of pharmacotherapy. Includes additional code information, definitions and NDC Crosswalks
  • National Drug Codes: Lookup drug information including r labelers, trade names, and dosage information.

Note: Find-A-Code does NOT include state-specific fee schedule information. Many states display some of their fee schedules on their websites.