CSHCN 2009 >5.6.2.5 National Drug Codes (NDC)

All CSHCN Services Program providers must submit an NDC for professional or outpatient electronic and paper claims submitted with physician-administered prescription drug procedure codes. Codes in the A code series do not require an NDC.

N4 must be entered before the NDC on claims. The NDC is an 11-digit number on the package or container from which the medication is administered.

The unit of measurement codes can also be submitted, however, are not required. The codes to be used for all claim forms are:

Depending on the claim type, the NDC information must be submitted as indicated below:


Block No.	Description	Guidelines
43	Revenue codes and description	Enter N4, the 11-digit NDC number (number on the package or container from which the medication was administered). Optional The unit of measurement code and the unit quantity with a floating decimal for fractional units (limited to 3 digits) can also be submitted, however, are not required. Do not enter hyphens or spaces within this number. Example: N400409231231GR0.025


Block No.	Description	Guidelines
24A	Date(s) of service	Optional In the shaded area, enter the NDC qualifier of N4 and the 11-digit NDC number (number on the package or container from which the medication was administered). Do not enter hyphens or spaces within this number. Example: N400409231231
24D	Procedures, services, or supplies	Optional In the shaded area, enter a 1- through 12-digit NDC quantity of unit. A decimal point must be used for fractions of a unit.
24G	Days or units	Optional In the shaded area, enter the NDC unit of measurement code.

The Texas Medicaid and CSHCN Services Program Top Physician-Administered Multiple-Source Drugs list is available on the TMHP website at www.tmhp.com. The list contains those physician-administered, multiple-source drugs that the U.S. Secretary of Health and Human Services has determined to have the highest dollar volume of physician-administered drugs that are dispensed through Medicaid.