Wiki Help...NDC

[cgillespie]

Can anyone explain to me which NDC # is correct to bill physician claims with when the drug box itself has 1 NDC # and on the vials they have a different NDC#? For example on my Medicaid claims for Rocephin 250 mg are getting denied. The Rocephin comes in a box of 10 vials.

Any advice and documentation would be appreciated.

 

[dnostdahl]

NDC # Rejection from the carrier

Good Evening -

What format is the NDC#? Our software vendor requires 5-4-2 format. So if an NDC# does not have 11-digits we have to add a 0 in the missing # space. I would check that first because your number sounds correct if you are getting directly off the bottle. Our software give us the option on what format we are adding even though the clearinghouse will only take the 5-4-2 11-digit format. I would use the NDC# off the drug box, and then we had to make sure the the unit calculation was matching on claims. So check the format of what is going electronically first and go from there.

Thanks, Dru