NDC Codes

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mbpros
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Joined: Fri Mar 11, 2011 6:59 pm

NDC Codes

Post by mbpros » Mon Oct 30, 2017 9:55 am

I have rarely had to bill drugs/injections but one payer is requiring NDC codes. I am a little unsure about stuff.

First, if I populate all of the required info for the CPT code (NDC code, NDC Unit of Measurement, Unit Price), does that info auto populate on the EDI claim or do I have to select any other option to ensure the NDC info goes on the claim?

Second, as an example I have an NDC code 49281028610 for CPT code 90700. I understand to enter that NDC Code, to enter ml as the unit of measurement and to enter $80 as the unit price. They are dispensing 0.50 ml so do I enter the default units as 0.50?

Thanks,
Steve
Steven Zats
Medical Billing Professionals

mbpros
Posts: 249
Joined: Fri Mar 11, 2011 6:59 pm

Re: NDC Codes

Post by mbpros » Mon Oct 30, 2017 9:57 am

Following up on the above, first I believe I have to enter N4 in the Code ID Qualifier field also, right?

Second, I cannot enter 0.50 as the default units so how do I enter 0.50 as the ml units for the claim?

Thanks,
Steve
Steven Zats
Medical Billing Professionals

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Gavin Walker
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Re: NDC Codes

Post by Gavin Walker » Tue Oct 31, 2017 7:50 am

If you are using Revenue Management to generate ANSI 5010 claims, you don't enter the Code ID Qualifier. That is automatically generate on the claim.

In Transaction Entry click the Details button. You should see all the NDC information defaulted in from the Procedure Code settings.

In the Receiver setup in Revenue Management, make sure you have the Send Drug Loop option checked.

kidspeds
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Joined: Sat Oct 03, 2015 10:37 am

Re: NDC Codes

Post by kidspeds » Tue Nov 28, 2017 1:06 pm

one payer is requesting 2 NDC codes(90698) which has 2 vials to be mixed before administration how to we enter it
Thanks
Usha

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Gavin Walker
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Re: NDC Codes

Post by Gavin Walker » Thu Nov 30, 2017 9:06 am

You set the NDC code on the Procedure Code and that defaults the Transaction Details button. You can setup additional procedure codes if necessary to reflect additional NDC codes.

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