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How Do You Bill An NDC Number?


The NDC must be submitted along with the applicable HCPCS/CPT code(s) and the number of HCPCS/CPT units. The NDC must follow the 5digit4digit2digit format ( 11-digit billing format, with no spaces, hyphens or special characters).

What is the purpose of NDC numbers?

Drugs are identified and reported using a unique, three-segment number called the National Drug Code (NDC) which serves as the FDA’s identifier for drugs.

How do I find my NDC number?

You can also access NDC numbers via the free Medication Guide App. The FDA also maintains a searchable database of NDC codes on their website. NDC numbers can also be found in the drug product labeling (for example, the package insert) as well as on the package itself.

What does the NDC tell you?

The NDC, or National Drug Code, is a unique 10-digit, 3-segment number. It is a universal product identifier for human drugs in the United States. The 3 segments of the NDC identify the labeler, the product, and the commercial package size.

What is NDC number?

NDC Number Each listed drug product listed is assigned a unique 10-digit, 3-segment number. This number, known as the NDC, identifies the labeler, product, and trade package size. The first segment, the labeler code, is assigned by the FDA.

How do I get a CMS 1500 form?

In order to purchase claim forms, you should contact the U.S. Government Printing Office at 1-866-512-1800, local printing companies in your area, and/or office supply stores. Each of the vendors above sells the CMS-1500 claim form in its various configurations (single part, multi-part, continuous feed, laser, etc).

How do you read NDC?

The NDC number consists of 11 digits, broken into 3 sections in a 5-4-2 format. The first 5 digits identify the labeler code representing the manufacturer of the drug and are assigned by the Food and Drug Administration (FDA). The next 4 digits identify the specific drug product and are assigned by the manufacturer.


Do NDC numbers expire?

When billing with NDCs on professional/ancillary/facility electronic (837P or 837l) or paper (CMS-1500) claims, it is important to ensure that the NDC used is valid for the date of service. This is because NDCs can expire or change.

What is NDC unit?

The National Drug Code (NDC) Billing Unit Standard designates four units of measure to describe all drugs: “UN” (unit), “ML” (milliliter), “GR” (gram) and “F2” (international unit). Each drug’s container label displays the appropriate unit of measure for that drug.

How many digits does an NDC number have?

The FDA held a public hearing on November 5, 2018, regarding the future format of the National Drug Code (NDC). An NDC is a unique 10-digit, 3-segment identifier which is assigned to all drugs in U.S. commercial distribution.

Where does the NDC go on a CMS 1500?

Where do I enter NDC data on a paper claim (CMS-1500 or UB-04)? CMS-1500: In the shaded portion of line-item field 24A-24G, enter NDC qualifier N4 (left-justified), immediately followed by the NDC. Enter one space for separation.

What is an NDC labeler code?

NDC labeler code is a ten digit unique, three-segment number which serves as a product identifier for human drugs. Third segment of NDC Labeler code identifies the package size and package type. The second and third segments are assigned by the labeler.

Do NDC numbers change?

The National Drug Code (NDC) number is a unique identifier for prescription drug products. The format, as explained by the FDA below, will need to be changed in the coming years to accommodate the entry of new labelers into the U.S. market.

Do vitamins have NDC codes?

Dietary supplements are not supposed to assign NDC number, even though a physician prescribes it.

Are NDC codes 10 or 11 digits?

It should be noted that many National Drug Code (NDC) are displayed on drug packing in a 10-digit format. Proper billing of a National Drug Code (NDC) requires an 11-digit number in a 5-4-2 format.

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