Quick Tip: Check Your Records for Outdated Drug Codes

Posted February 20, 2014

When billing with National Drug Codes (NDCs) on medical professional/ancillary electronic (837P) or paper (CMS-1500) claims, it is important to ensure that the NDC used is valid for the date of service. This is because NDCs can expire or change. An NDC’s inactive status is determined based on a drug's market availability in nationally recognized drug information databases. Additionally, an NDC is considered to be obsolete two years after its inactive date. It is a good idea to conduct a periodic check of records or automated systems where NDCs may be stored in your office for billing purposes. To help ensure that correct reimbursement is applied, the NDC on your claim should match the active NDC on the medication’s current label or packaging. Inactive products will continue to be reimbursed until they become obsolete. 

For more quick tips to assist you with billing for drugs on medical claims, view the NDC Billing Guidelines and answers to Frequently Asked Questions in the Claims and Eligibility/Claim Submission section.