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Billing Drugs NDC# Questions

  1. #1
    Default Billing Drugs NDC# Questions
    Clearnace Sale
    Drug codes (HCPCS) codes are billed with the NDC# to Medicare.
    Are the NDC# required for the commercial carriers also?
    If a drug code says 1 mg and 30 mg was administered and NDC# stands for a 30 mg dosage, do we put units with the HCPCS code and/or NDC?

    Thanks in advance for any responses here.

  2. #2
    St. Cloud, MN
    Post Ndc
    I have been using the NDC number as information only and using the HCPCS definition for quantities billed and have not had any issues with this. Not sure if it is 100% accurate, but this is worked for me.

  3. #3
    Columbia, MO
    some carriers are now requiring the NDC # in order for your J code to be reimbursed. This number goes in the shaded line above the J code. You use N4 then no space and the NDC number, one space the drug name then 3 spaces and the UN or QT code this all comes from the packaging or is on the vial. The units relates to the number of vials used if the drug comes as a 30mg vial and you gave 30mg then you gave 1 unit. This information is in the NUCC CMS 1500 billing manual

    Debra A. Mitchell, MSPH, CPC-H

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