Wiki Reporting NDC when multiple SDV vials are used on the patient

[rachelb117]

I have been getting conflicting information from our insurance carriers and conflicting denials. Say a patient presented for Mvasi infusion. The following vials were used:

120 units of SDV with NDC 55513-0207-01
20 units of SDV with NDC 55513-0206-01
29 units with 1 unit waste of NDC 55513-0206-21

Now Medicare for my area does not require NDC, so this would be easy for Medicare: Q5107 x169 and Q5107-JW x1

United Healthcare and some BCBS require NDC but are denying when we are reporting all the lines as above! Please help me bring clarity to the insanity!!! How are you guys reporting this? Are you getting denials that don't make sense!!

 

[tkermode]

I don't know what EMR you use, but we use Epic and it allows multiple NDCs per line. Previously, we were told one line per NDC but when we do that it gets denied, so we nest the NDCs.

EDIT: Wait, Rachel is that you? O.O

 

[sls314]

I don't know what EMR you use, but we use Epic and it allows multiple NDCs per line. Previously, we were told one line per NDC but when we do that it gets denied, so we nest the NDCs.

EDIT: Wait, Rachel is that you? O.O

If you're thinking of Rachael W, she does use this forum but her screen name is her full name.

(I took a guess that you might be posting about that Rachael, since you're a CHONC too.)