syprice
Contributor
I continue to get denials for J1050 I've used 3 different NDC 00548540025,00597623741, 00009074630
any suggestion would be greatly appreciated. Thanks
any suggestion would be greatly appreciated. Thanks
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Wiki NDC DEPO
- Thread starter syprice
- Start date
thomas7331
Guest
The first and third NDC look valid to me (I don't find 00597623741 though). What are the denials saying? It could be the payer's error, or it could be a problem with the formatting of the drug information on the electronic claim. Hard to say. Have you talked to the payer about it?
syprice
Contributor
The denial is invalid NDC code
nielynco
True Blue
Did you check the NDC on the package it came in? When I did the NDC lookup using the FDA site I got 59762-4537-1 with no leading zeros. Does your payer specify whether they want a 10 or 11 digit format?
nielynco
True Blue
I also found this interesting explanation on the FDA site with regard to NDC numbers:
Each listed drug product listed is assigned a unique 10-digit, 3-segment number. This number, known as the NDC, identifies the labeler, product, and trade package size. The first segment, the labeler code, is assigned by the FDA. A labeler is any firm that manufactures (including repackers or relabelers), or distributes (under its own name) the drug. The second segment, the product code, identifies a specific strength, dosage form, and formulation for a particular firm. The third segment, the package code, identifies package sizes and types. Both the product and package codes are assigned by the firm. The NDC will be in one of the following configurations: 4-4-2, 5-3-2, or 5-4-1.
Since the NDC is limited to 10 digits, a firm with a 5 digit labeler code must choose between a 3 digit product code and 2 digit package code, or a 4 digit product code and 1 digit package code.
Thus, you have either a 5-4-1 or a 5-3-2 configuration for the three segments of the NDC. Because of a conflict with the HIPAA standard of an 11 digit NDC, many programs will pad the product code or package code segments of the NDC with a leading zero instead of the asterisk.
Since a zero can be a valid digit in the NDC, this can lead to confusion when trying to reconstitute the NDC back to its FDA standard. Example: 12345-0678-09 (11 digits) could be 12345-678-09 or 12345-0678-9 depending on the firm's configuration.