# Q9966 NDC invalid?



## lburns23 (May 22, 2019)

Hello!

Our office does many of our procedures under fluoroscopy guidance, and I bill for the contrast using CPT code Q9966 with NDC 0270131530, this is what's on the bottle, and they are not expired. However, several insurances have begun denying this code (particularly UHC) saying the NDC is invalid/withdrawn.

My office coordinator says there is a current national shortage of the Isovue we use; I'm wondering if they're releasing a new one with a new NDC, and this may be why they are denying.

Has anybody else experienced this? How do I argue with the insurance company that the NDC is correct for what we are using? I know it doesn't reimburse much (about 34 cents, woohoo) but they do add up when we do 15-20 procedures a day, several days a week.

Thank you!


----------



## thomas7331 (May 22, 2019)

NDC numbers require 11 digits and you only have ten so that's likely your problem.  In this case, you'll need to add a leading zero in the location where it is missing.  The format of the NDC should be 5-4-2, or XXXXX-XXXX-XX, so if you look at the bottle to see where the dashes are, they will have dropped a number in one of those segments.  You add a leading zero at the beginning of that segment to bring it to 11 digits - I think for Isovue it is 0270-1315-30, should you would submit 00270131530 on your claim - that should work for you.


----------



## trarut (May 22, 2019)

I would add that it's a good idea to verify the NDC for the stock you used/have on hand hasn't changed, just to be sure before you submit the correction


----------



## CodingKing (May 22, 2019)

00270-1315-30  is Isovue-300 61 % SOLN which falls under Q9967


----------



## lburns23 (May 22, 2019)

CodingKing said:


> 00270-1315-30  is Isovue-300 61 % SOLN which falls under Q9967



Ahh yes!! I double-checked the bottle vs the HCPCS book and you are correct! I think this is most likely the issue. Thank you!


----------



## renee dustman (May 23, 2019)

There's a good article on the NDCs that talks about the 0 discrepancy:
https://www.aapc.com/blog/45887-product-specificity-matters-when-using-national-drug-codes/


----------



## Priiis1 (Jul 22, 2019)

What if the NDC code on the vial is not a valid NDC code?  Do you use J3490?


----------



## trarut (Jul 23, 2019)

No, you wouldn't use J3490.  You need to figure out why the number isn't valid and it's most likely missing a digit somewhere.  (Although the Medicaids are notorious for denying for invalid NDCs just because the number isn't in their database.)  What is the NDC number as listed on the vial?


----------

