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December 2016 Texas Medicaid Provider Procedures Manual

Section 6: Claims Filing : 6.3 Coding : 6.3.4 National Drug Code (NDC) : NDC Requirements for Dual Eligible Clients
The 11-digit NDC, NDC quantity, and NDC Unit of measure information is required on all professional and outpatient clinician-administered drug claims for dual-eligible clients. These drug claims are submitted to Medicare, which will cross over to Medicaid for consideration of coinsurance and deductible liabilities.
Claims which cross over without this required information may be denied due to missing, incomplete, or invalid NDC information. This information applies to all Medicaid providers who serve Medicare-Medicaid dual-eligible clients.
Providers may refer to subsection 6.3.4, “National Drug Code (NDC)” in this section for more information on NDC requirements. The Texas NDC-to-HCPCS Crosswalk identifies relationships between HCPCS codes.

Texas Medicaid & Healthcare Partnership
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