New 5010 NDC claim requirements

EmilyD

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Melissa, TX
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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?
 

Melissa_M

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St. George Utah Chapter
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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.:)
 
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