Wiki NDC Unit vs CPT description

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midnight1995

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If any one can help, I have been back and forth with this regarding J codes and what information needs to go out for the NDC unit
Example: J1040 80mg
a.) The NDC number 11 digit 70121157301 - National Drug Unit: and Drug UOM - = ML: The question is the National Drug Unit should this be 80 - I have several answers: as this should be 1 but when the NDC populated on the claim to me its stating 1 ML
b.) The CPT level there is not issue as the CPT unit is 1.

Example J1885, per 250mg
a.) The NDC - National drug unit is the question should it be 1 or 250ml

Any help would be great. thank you
 
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Since the NDC unit is ml, you will need to convert you mg to ml based on the strength of the mixture. So in your first example, 80 mg was given to the patient, for 1 units on the HCPCS code. The strength of the mixture for NDC #70121157301 is 40mg/ml, which means that in order to administer 80 mg, the provider would have needed to give 2 ml. So your NDC UOM should be ML2

I'm not able to help with the second example because you haven't given the NDC number or the strength that your provider is using, but you'd need to make the same conversion. For the UOM, you need to identify the number of ml that was actually administered, which will vary depending on the preparation that is being used. There isn't a straight conversion from mg to ml without knowing what the strength was.
 
midnight1995 said:
Great
J1885 per 15 mg
The NDC for the 2nd - is 70860070104 30mg/ml - so based on the above the NDC UOM would be ML2 and CPT unit = 2
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How much was given to the patient? If 15 mg was given, and if it's 30 mg/ml, then HCPCS units would be 1 but the volume given would be 0.5 ml. In other words, for every 1 ml given, you'll be billing 2 units on the HCPCS code for this strength.
 
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