Is the NDC required on an outpatient claim if a drug is not reimbursed by Medi-Cal?
Medi-Cal encourages providers to use the NDC for every claim. If a claim is denied, then providers will receive the correct reason code for the denial. For example: If the drug is billed with the NDC and it is not reimbursed by Medi-Cal, the denial reason code will indicate that the drug was not covered. Any claim billed without the NDC will be denied because the NDC was not entered. It will appear as if the provider made a mistake so the denial code may not be accurate.
