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NDC Codes

Posted: Mon Oct 30, 2017 9:55 am
by mbpros
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

Re: NDC Codes

Posted: Mon Oct 30, 2017 9:57 am
by mbpros
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

Re: NDC Codes

Posted: Tue Oct 31, 2017 7:50 am
by Gavin Walker
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.

Re: NDC Codes

Posted: Tue Nov 28, 2017 1:06 pm
by kidspeds
one payer is requesting 2 NDC codes(90698) which has 2 vials to be mixed before administration how to we enter it
Thanks
Usha

Re: NDC Codes

Posted: Thu Nov 30, 2017 9:06 am
by Gavin Walker
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.