National Drug Code Numbers: The Key to Accurate Medication Billing
Hello, healthcare professionals! In today’s blog post, we will explore an essential aspect of medical billing – NDC numbers (National Drug Code numbers). Understanding NDC numbers is crucial for accurate medication billing, ensuring that payers reimburse the right drugs. Let’s dive into the world of NDC numbers, how to utilize them effectively, and avoid common pitfalls.
What are National Drug Code Numbers?
NDC numbers, or National Drug Code numbers, are 11-digit codes uniquely identifying medications and vaccines in the United States. These codes are significant in medical billing because they must be attached to any drugs billed on a claim. NDC numbers help payers verify the medications’ accuracy, ensuring proper reimbursement to healthcare providers.
Where to Find NDC Numbers:
You can find the NDC number on the medication bottle or packaging. It’s essential to accurately record these numbers in your electronic health record (EHR) system to facilitate seamless billing.
Setting up NDC Numbers in your EHR:
Setting up NDC numbers is crucial for streamlined billing using an EHR system. While some EHR systems can automatically attach NDC codes to corresponding CPT codes, it’s often manual, especially for less common drugs. Here’s how to do it:
Review Common CPT Codes: Identify the most frequently used CPT codes (J codes) for drugs you bill. These are essential for associating NDC numbers correctly.
Populate the Master Directory: Enter the corresponding NDC numbers for each CPT code in your EHR’s master directory. This directory acts as a reference for your billing system.
Verify Accuracy: Ensure that the NDC numbers you enter match the drug’s name, dose, and formulation billed under the specific CPT code.
Utilize Billing Resources:
Billing resources, like the website Buying.com, can be incredibly helpful in verifying medication details and billing units for specific CPT codes. This resource can assist you in cross-referencing NDC numbers, ensuring accurate medication billing.
Vaccines and NDC Numbers:
It’s crucial to note that vaccines also have associated NDC numbers. When dealing with Vaccines for Children (VFC) programs or government-supplied vaccines under Medicaid, separate NDC numbers may exist for the same vaccine based on payment type:
VFC vs. Commercial Insurance: Vaccines supplied under VFC programs may have different NDC numbers than those billed to commercial insurance.
Attention to Detail is Key:
Pay attention to the finer details when entering NDC numbers:
Matching NDC and CPT Codes: Ensure that each CPT code is accurately associated with the correct NDC number for each drug.
Full 11-Digit NDC Numbers: Some NDC numbers may have only nine digits. Your EHR should guide you on completing them with zeros as placeholders to create the full 11-digit code.
Invalid NDC Numbers: Payers will reject claims with invalid ones, so double-check for accuracy.
National Drug Code numbers are vital for accurate medication billing. Properly associating NDC codes with CPT codes in your EHR will facilitate seamless billing and ensure that you receive appropriate reimbursement for medications provided to patients. Attention to detail and careful verification will go a long way in avoiding billing errors and rejected claims.
Please leave your questions and comments below if you found this information helpful. Thank you for joining us today, and we wish you a successful and error-free billing experience. Take care and have a wonderful day!
[Disclaimer: The information provided in this blog post is for general informational purposes only and should not be considered professional advice. Always consult your EHR vendor or a qualified healthcare consultant for specific guidance on setting up NDC numbers in your system.]