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PostPosted: Thu Jan 18, 2018 8:58 am 

Joined: Fri Mar 11, 2011 6:59 pm
Posts: 232
Is there a way to only send NDC codes to certain payers for CPT codes? I am thinking it's not possible to use one CPT code and only send NDC codes to certain payers, but not to send to others. It appears the best option is to create a different Code 1 (then list the correct CPT code in the Alternate Codes) for the payers that do want the NDC codes.

As another question, since I do not bill NDC codes often, is there any harm in billing NDC codes to a payer that normally does not require them. We have some CPT codes where most payers pay them without an NDC code but United HC requires the NDC codes. If I billed the NDC codes to all payers could that affect how the other payers process the claims?


Steven Zats
Medical Billing Professionals

PostPosted: Fri Jan 19, 2018 12:38 pm 
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Joined: Wed Apr 04, 2007 10:11 pm
Posts: 4070
Location: Springfield, MO
You could setup another receiver record on one you check the option to send the drug loop and on the other you do not check it. Setup the desired receiver on each payer accordingly. You'll have to send the claims in two different batches.

I don't see how it could be harmful to send an NDC code to a payer that doesn't use it.

Gavin Walker
Walker Tek Solutions, LLC

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