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June 20, 2019

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

UPDATE - Effective 10/01/2019, any professional, ancillary, or institutional outpatient facility claim that includes drugs (J 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.

Claims submitted with Q and C codes, between 5/21/2019 and 5/28/2019, that rejected for not containing an NDC, can now be resubmitted.

Claims submitted with J codes, between 5/21/2019 and 6/20/2019, that rejected for not containing an NDC, can now be resubmitted.

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