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December 2016 Texas Medicaid Provider Procedures Manual

Medicaid Managed Care Handbook : 3 STAR Program : 3.3 STAR Program Benefits : 3.3.3 National Drug Code

3.3.3
All STAR providers that submit professional or outpatient claims with physician-administered prescription drug procedure codes are required to use the associated NDC. Drug claims submitted with procedure codes in the “A” code series do not require an NDC. The NDC is only required on outpatient hospital claims and physician claims.
N4 can 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.
Refer to:
Subsection 6.3.4, “National Drug Code (NDC)” in Section 6, “Claims Filing” (Vol. 1, General Information).

Texas Medicaid & Healthcare Partnership
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