Patricia Posted Sun 05th of November, 2017 13:03:56 PM
I am getting numerous denials on the above CPT codes stating NCD denials? I have verified the NDC on this site. My concern is the NDC on this bottle is not on your NDC list for the CPT codes. Any help would be great.
SuperCoder Answered Mon 06th of November, 2017 01:59:13 AM
Could you please provide the name of the drug administered and the NDC on the bottle(s) for both the CPT codes mentioned above.
NOTE: Billing for medication and vaccines
Following are some general concepts for the use of NDC numbers when submitting claims for medications or vaccines, but refer to your payers for specifics.
In general, the requirements to report a medication or vaccine are:
The applicable Healthcare Common Procedure Coding System (HCPCS) code or Current Procedural Terminology (CPT) code
Number of HCPCS code or CPT code units
11-digit NDC(s), including the N4 qualifier (which indicate the use of the NDC)
Dosage unit of measurement
Number of NDC units dispensed (must be greater than 0)
Patricia Posted Mon 06th of November, 2017 10:57:41 AM
CPT 90686 FLUZONE
National Drug Code ------> 49281-417-88
NDC Units of Measure ----> ml
NDC Quantity ------------> 0.5
Lot Number --------------> UT5936KA
Lot Expiration Date -----> 06/30/2018
Manufacturer Code -------> PMC
Anatomical Route --------> IM
SuperCoder Answered Tue 07th of November, 2017 01:47:03 AM