Wiki UHC Keep denying NDC code for J0702

[Biller2023]

We billed J0702 with NDC 05170720010 but UHC denied stating MISSING/INCOMPLETE/INVALID/ DEACTIVATED/WITHDRAWN NATIONAL DRUG CODE, so I changed NDC to 00085056605 and resubmitted but again it was denied for the same reason. reason. We have received payments from other insurance for the same NDC for J0702 so not sure why UHC is not paying.

 

[thomas7331]

In the first example, you’ve added the extra zero in the incorrect place, UHC requires the format 5-4-2, so the NDC should be 00517072001 (add the zero at the beginning of the group that is missing a digit).

The second example looks correct to me, so I’m not sure why that would have denied, possibly that NDC requires a different HCPCS code.

UHC uses an outside vendor to provide the NDC-HCPCS code matches, and they do sometimes make errors that may be corrected in the next quarterly update. Unfortunately, they do not share this information with providers so there can sometimes be some guesswork involved in trying to understand what they’re looking for.