Q9966 NDC invalid?

lburns23

Contributor
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Tucson, Arizona
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Hello!

Our office does many of our procedures under fluoroscopy guidance, and I bill for the contrast using CPT code Q9966 with NDC 0270131530, this is what's on the bottle, and they are not expired. However, several insurances have begun denying this code (particularly UHC) saying the NDC is invalid/withdrawn.

My office coordinator says there is a current national shortage of the Isovue we use; I'm wondering if they're releasing a new one with a new NDC, and this may be why they are denying.

Has anybody else experienced this? How do I argue with the insurance company that the NDC is correct for what we are using? I know it doesn't reimburse much (about 34 cents, woohoo) but they do add up when we do 15-20 procedures a day, several days a week.

Thank you!
 

thomas7331

True Blue
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NDC numbers require 11 digits and you only have ten so that's likely your problem. In this case, you'll need to add a leading zero in the location where it is missing. The format of the NDC should be 5-4-2, or XXXXX-XXXX-XX, so if you look at the bottle to see where the dashes are, they will have dropped a number in one of those segments. You add a leading zero at the beginning of that segment to bring it to 11 digits - I think for Isovue it is 0270-1315-30, should you would submit 00270131530 on your claim - that should work for you.
 

trarut

Guru
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Columbus, OH
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I would add that it's a good idea to verify the NDC for the stock you used/have on hand hasn't changed, just to be sure before you submit the correction :)
 

trarut

Guru
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249
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Columbus, OH
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No, you wouldn't use J3490. You need to figure out why the number isn't valid and it's most likely missing a digit somewhere. (Although the Medicaids are notorious for denying for invalid NDCs just because the number isn't in their database.) What is the NDC number as listed on the vial?
 
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