National Drug Codes

National Drug Codes Explained

It is a unique 10-digit or 11-digit, 3-segment number, and a universal product identifier for human drugs in the United States. NDC code requires for Drug CPT code like – J1055.  Example of NDC code N40003029305

Important Points:

• In CMS1500 form, the NDC code can be located in line-item field 24A-24G.
• In the UB04 form, the NDC code is available in field 43.
• The 11-digit NDC is separated into three segments in a 5-4-2 format. Sometimes the NDC on the label does not include the 11 digits in that case it will be necessary to add a leading zero to the appropriate section to create a 5-4-2 configuration in the following sample. 5-3-2 (50242-040-62) should be made 5-4-2 (50242-0040-62)
• The 3 segments of the NDC identify: the labeler, the product, and the commercial package size.
  • The first set of numbers in the NDC identifies the labeler code and is assigned by the FDA. It reflects the drug manufacturer, or distributer.
  • The second set of numbers is the product code, formulation of a drug for a particular firm (i.e., capsule, tablet, liquid)
  • The third set of numbers is the package code, which signifies package sizes and types.
• For drugs that come in a vial in powder form, bill each vial in units (UN).
  • For drugs that come in liquid form, bill in milliliters (ML).
  • For topical forms of medicine, bill in grams (GR).
• The format for the billing should be: N4 + NDC number+ three spaces + unit of measure + quantity. for example, N40003029305
• • N4 represents NDC qualifier
  • 40003029305 represents NDC code
  • ML/UN/GR represents unit of measure
  • Last numerical digit represents quantity

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