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April 25, 2019

Attn: New York Customers - New National Drug Code (NDC) Requirement Information

Effective May 21, 2019, any professional, ancillary, or institutional outpatient facility claim that includes drugs (J, C, or Q codes) covered under the medical benefit must also include a valid National Drug Code (NDC), which corresponds to the Healthcare Common Procedure Coding System (HCPCS). This applies to both classified and unclassified (NOC) codes as well as both electronic and paper claim submissions. As there are often several NDCs linked to a single HCPCS, each NDC must be submitted on a separate claim line even if the HCPCS code is the same. If the required NDC information is not included on claims submitted on or after May 21, 2019, your claim will be denied.