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Kerri Posted Tue 28th of April, 2015 15:57:04 PM

I have a question about NDC numbers. Isn't it a LAW that the NDC number be on the claim? I have a (REALLY BIG) insurance company telling me they will pay me MORE money if I leave the NDC off the claim. This doesn't sound right to me... Anyone else been told this by an insurance company? They are also telling me that if I want to use the NDC I shoud just use 2.5 units instead of 1. That bumps the AWP up and I will get paid more.

SuperCoder Answered Wed 29th of April, 2015 06:01:49 AM

Guidelines may differ basis payer, however usually it is mandatory in case you are an NDC provider (typically home infusion and/or a specialty pharmacy provider).

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