Monthly Archives: April 2016

NDC Numbers

So, I just learned something today. About NDC numbers. 

When the NDC number from the label of our medication was not 11 digits, I would add a zero in front of the NDC number when I set up the codes in my system. Recently, I have been having issues with Blue Cross and the NDC for Avastin; they keep sending me rejections stating the NDC is not correct. I checked and double checked on the label of the bottle of medication in the doctor’s fridge that the NDC number I used was correct. A couple of LOOONNNG, irritating phone calls with Blue Cross and some judicious Googling later, I have found the answer. 

The zero does not always go in front of the number. Sometimes it goes in the middle of the number and sometimes it goes at the end-ish of the number. And yes, sometimes we have to add one in front. It depends on how the digits of the NDC number are grouped and where the dashes are placed. Here is the breakdown:

10-digit format:                              Add zero  

4 digits-4 digits-2 digits           1st position – Example: 01111-2222-33       Example: 1111-2222-33

5 digits-3 digits-2 digits           6th position – Example: 99999-0888-77  Example: 99999-888-77

5 digits-4 digits-1 digits            10th position – Example: 44444-5555-01  Example: 44444-5555-1 

Here is our real world example. My NDC number for Avastin is 50242-060-01. I had been sending it to Blue Cross with the zero in front. But the correct format is 50242006001. Please remember, most clearinghouses will reject an NDC number if you put the dashes in. I am refiling so, so, so many Avastins to Blue Cross now. Wish me luck. 

 

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Filed under Avastin, blue cross, Medical Billing