What is an NDC?
The NDC is a universal number that identifies a drug. The NDC number consists of 11 digits in a 5-4-2 format. The first five digits identify the manufacturer of the drug and are assigned by the Food and Drug Administration. The remaining digits are assigned by the manufacturer and identify the specific product and package size. Some packages will display less than 11 digits, but leading zeroes can be assumed and need to be used when billing. For example: XXXX-XXXX-XX = 0XXXX-XXXX-XX XXXXX-XXX-XX = XXXXX-0XXX-XX XXXXX-XXXX-X = XXXXX-XXXX-0X The NDC is found on the drug container (that is vial, bottle, tube). The NDC submitted to MassHealth must be the actual NDC number on the package or container from which the medication was administered. Do not bill for one manufacturer’s product and dispense another.
Related Questions
- If the required NDC information is missing, will the entire claim be denied or just the claim line for the physician-administered drug?
- Are the NDC and unit of measurement required on a crossover claim when billing with either the UB-04 or CMS-1500 claim forms?
- What is the final implementation date when providers will only be able to use the NDC on claims?
