National Drug Code Reporting Requirements

National Drug Code Reporting Requirements

November 12, 2015

BlueCross® BlueShield® of South Carolina and BlueChoice HealthPlan currently accept National Drug Codes (NDCs) for billing of all physician or ancillary provider-administered and supplied drugs. Effective Jan. 1, 2016, BlueCross and BlueChoice® will require the reporting of the NDC, NDC unit of measure and NDC quantity for all outpatient-administered drug claims.

As a reminder, when submitting NDCs on professional electronic and paper (CMS-1500) claims, you must include this related information:

 

  • 11-digit NDC
  • NDC qualifier (N4)
  • NDC quantity
  • NDC unit of measure [Unit (UN), Milliliter (ML), Gram (GR), International Unit (F2)]

You can find additional information about the NDC requirements and the Drug Rebate Program in the Provider News section of our website at www.BlueChoiceSC.com. You can also find additional NDC information, as well as an NDC to Healthcare Common Procedure Coding System (HCPCS) crosswalk, on the Centers for Medicare and Medicaid Services website.

Please contact Provider Education for information about this bulletin at provider.education@bcbssc.com or by calling 803-264-4730.

BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association.