National Drug Code Required for Drug/Radiopharmaceutical Not Otherwise Classified Codes
The National Drug Code (NDC) number, name and dosage are required for all 'not otherwise classified' or 'unlisted' HCPCS procedure codes for drugs and radiopharmaceuticals (J3490, J3590, J9999, A4641, A9699 and A9700).
- For electronic claims: submit this information in the electronic documentation record (2400-NTE, 02)
- For paper claims: submit this information in Item 19 or an attachment to the CMS-1500 claim form
- Note: The FDA standard is a 10 digit number, but to be compliant with the HIPAA standard of an 11 digit code, you may use a leading '0' to pad the number
- Claims for unlisted drugs or radiopharmaceuticals that are submitted without this information will be returned as unprocessable and must be submitted as new claims