Avoid National Drug Code Billing Errors

May 2024

Avoid National Drug Code Billing Errors

Submitting claims with the appropriate NDC information is important for claims processing and may help you spend less time troubleshooting a rejected claim line.

One common error is using the NDC number from individual vials instead of the NDC number on the box when medication comes in a box with multiple vials.

The best option is to use the NDC number on the box (outer packaging), along with the appropriate NDC unit of measure and NDC units.
You should do this whenever possible to support accurate processing of your claim – with fewer unnecessary claim rejections.
Not all NDC numbers on vials have manufacturer pricing to support an allowance, so outer packaging NDC numbers are the preferred method of NDC claim submission.

Providers participating in our PPO and Blue Choice PPO^SM networks may access and obtain the NDC Reimbursement Schedule by using the Plan Documents Viewer on Availity^® Essentials.

For more information, refer to the NDC Billing Guidelines and other important information on our Specialty Pharmacy Program page.

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