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Previous Next. The code is present on all nonprescription over-the-counter and prescription medication packages and inserts in the United States. Many NDC numbers listed on drug packaging are in 10 digit format. The NDC number is essential for proper claim processing when submitting claims for drugs used. However, to be recognized by payers, it must be formatted into an 11 digit sequence.
This requires a zero to be placed in a specific position to meet the format requirement. As not all NDC numbers are set up the same, the table below provides examples of appropriate position of the zero based on the three segment numbers listed on the packaging. While many practice management systems automatically remove the hyphens, be sure they are excluded from submission on the claim.
About Foundation Museum of the Eye. Coding for Injectable Drugs. Remarks are required to include dosage, name of drug, and route of administration. You cannot bill for drugs that can be self-administered. The injection must be administered by physician. Do not bill units based on the way the drug is packaged, stored, or stocked. Do not bill for the full amount of a drug when it has been split between two or more patients.
Only bill for the amount given to each patient. Reference: OIG report April When billing injections, always include the HCPCS drug code, even when no payment from the payer is required. Single-Use Vials Whether there is waste or not, submit the number of units assigned to the drug.
Multiple Use Vials Insurance companies will only pay for the amount administered to the patient and will not pay for any discarded amounts of the drug. Botulinum Toxins For Medicare Part B patients, payment policy allows for only one injection code per side of the body regardless of the number of needle passes made into the site. Proper documentation of complex or multiple injection sites can support and warrant additional reimbursement with some commercial payers while others pay one amount regardless of the number of injections.
Drug Wastage If the remainder of a vial must be discarded after being administered, insurance will cover the amount discarded as well as the amount administered.