Wiki New 5010 NDC claim requirements


Melissa, TX
Best answers
I've spent hours searching the new NDC requirments but haven't found clear answers. If anyone could help answer these questions, it would be greatly appreciated.

1. I found a link to CMS that said that Medicare Part B turned this edit off as of Dec 9, 2011 and the NDC information is not required right now. Is there a new date when it will take effect again? What about other insurances (not Medicaid)?

2. Is "ME" for milligrams an accepted unit of measurement now (our vendor says yes) but I can't find it on CMS website. Other sites say you have to convert to ML which seems complicated. :confused:

3. What exactly is the new UNIT field supposed to be? The HCPCS dosage amount for 1 unit -or- the amount administered to the patient?
Example: Remicade J1745 is 10 mg for 1 unit - the patient received 300 mg.
Unit of measurement: ME
Unit amount: 10 for 1 unit per HCPCS description or 300 what patient received?
When a patient received a reconstituted medication such as Rocephin then you use UN x the units: 250 mg=1unit, 500 mg=2 units, 750mg=3 units and 1 gram =4 units. We always bill an ML for other theraputic injections.

Hopefully this will be helpful.:)