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July 3, 2018

National Drug Code (NDC) Claim Editing

EDI Front End editing will be implemented within the next 60 days validating National Drug Code (NDC). NDC codes are submitted in the 2410 LIN.

The HIPAA standard NDC format requires 11 digits but the FDA only assigns 10. A leading 0 must be added to the appropriate segment to bring the total to 11. There are three segments; the first identifies the packager of the product and will have 4 or 5 digits, the second identifies the drug and will have 3 or 4 digits and the third represents the package size and will have 1 or 2 digits. A leading zero must be added to the appropriate segment to bring it to the 5-4-2 HIPAA format. Here are some examples:

5555-4444-22 would become 05555-4444-22 submitted in the 2410 LIN 05555444422

55555-444-22 would become 55555-0444-22 submitted in the 2410 LIN 55555044422

55555-4444-2 would become 55555-4444-02 submitted in the 2410 LIN 55555444402


 

 

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