19 May Proper Use of the National Drug Code Directory in Medical Billing
Medical billing and coding involves a range of information, including the use of various codes. Physicians and others who write prescriptions, which have a corresponding identifier in the National Drug Code (NDC), rely upon those who are submitting their insurance claim forms to payers to be accurate when utilizing the National Drug Code Directory (NDCD).
This searchable database, which is provided by and maintained by the Federal Drug Administration (FDA), contains the identifying code for every drug for which a medical practitioner might write a prescription and, also, for all non-prescription drugs.
The NDCD is a massive catalogue of codes that’s updated on a daily basis. Over time, the FDA has focused its efforts on simplifying the code, which has resulted in numerous versions of these identifiers. Having an understanding of how these 10-digit, 3-segment numeric identifiers work is essential for a medical billing and coder professional. The code is fairly complex, and even the simplest mistake can put a medical claim in jeopardy.
As an example, consider the following code: NDC 0777-3105-02. In terms of looking up this code, this is the code for a 100-count bottle of Prozac (20 mg). The first set of numerals, which numbers four, relates to the labeler, which in this case is Dista Products Company. The second set of four numbers indicates the product code, strength of dosage, and form of medicine. The segment 3105 is for Prozac, capsules at 20 mg each. The final two numbers, the package code, identify the package type and size. This two-digit number is for a bottle of 100 capsules.
Consider how many different various dosages and sizes of the same medicine exist and how easy it would be to make an error. Then add in the thousands upon thousands of drugs that are classified by the NDC and how this catalogue continues to expand. Accuracy is incumbent for the successful submission of each medical claim, and understanding the code and working with it everyday helps to ensure that it is recorded right the first time.
Working with Professionals
A healthcare professional can benefit from working with medical and billing coding professionals who specialize in all aspects of the highly complicated medical billing process. Of course, NDCD is just one element in this process, but a missing, incomplete, or inaccurate code will result in the rejection of a claim and the need to resubmit a corrected version. That simply slows down and delays the reimbursement process, and that’s something that no healthcare provider can afford.
If you have questions concerning the NDC, the use of the code, or the medical billing and processing, please contact the professionals at Medical Practice Management Resources, Inc. We will be happy to discuss how we can help your practice run smoothly, process medical claims, and be more profitable.
Although the NDC is a standardized system, we understand that each medical practice is a unique entity and we’re dedicated to serving each of our clients in an individualized and personalized manner.