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Are you submitting claims correctly for medications that come in additional packaging?

July 9, 2020

Submitting claims with the appropriate National Drug Code (NDC) information can help with claims processing and help you spend less time troubleshooting a rejected claim line.

A common question PDF Document is, “If a medication comes with additional packaging like a box with multiple vials, which NDC information should be submitted on the claim? Is it the NDC number on the box (outer packaging), or the NDC number on the individual vial?”

In these cases, the best option is to use the NDC number on the box (outer packaging), along with the appropriate NDC unit of measure and NDC units. You should do this whenever possible to help improve claims processing and to have fewer unnecessary claim rejections. Not all NDC numbers on vials have manufacturer pricing to support an allowance, so outer packaging NDC numbers are the preferred method of NDC claim submission.