TMPPM 2008 >7.1.11.1 National Drug Code (NDC) Claims

All providers that submit professional or outpatient claims with physician-administered prescription drug procedure codes for PCCM and STAR voluntary SSI will be required to use the associated NDC.

Drug claims submitted with procedure codes in the "A" code series will not require an NDC. The NDC is only required on outpatient hospital claims and physician claims.

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.

Depending on the claim type, the NDC information must be submitted as indicated below.If submitting on a UB-04 CMS-1450 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 package or container from which the medication was administered), the unit of measurement code, and the unit quantity with a floating decimal for fractional units (limited to 3 digits). Do not enter hyphens or spaces within this number. Example: N400409231231GR0.025

If submitting on a CMS-1500 the NDC information must be submitted as indicated below:


Block No.	Description	Guidelines
24A	DOS	In the shaded area, enter the NDC qualifier of N4 and the 11-digit NDC number (number on 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	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	In the shaded area, enter the NDC unit of measurement code.