Effective Jan. 1, 2016, BlueCross® BlueShield® of South Carolina and BlueChoiceHealthPlan required the reporting of the NDC, NDC unit of measure and NDC quantity for institutional outpatient and professional claims.
Effective March 25, 2016, claims submitted electronically without the NDC requirements will reject at the gateway with the below error codes. Please work with your clearinghouse to avoid claim payment delays.
| Denial Code
|| NDC IS INVALID FOR THE HCPCS/CPT4 CODE
|| NDC IS BLANK OR INVALID
As a reminder, when submitting NDCs you must include this related information:
- Valid 11-digit NDC
- NDC qualifier (N4)
- NDC quantity
- NDC unit of measure (UN – Unit, ML – Milliliter, GR – Gram, F2 – International Unit)
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 HCPCS crosswalk, on the Centers for Medicare and Medicaid Services website.
Please contact Provider Education for information about this bulletin at email@example.com or by calling 803-264-4730.
BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association.