National Drug Code (NDC) Billing Update for BCBSIL Medicaid Claims

Posted April 25, 2017 (Updated April 26, 2017)

Blue Cross and Blue Shield of Illinois (BCBSIL) is implementing Medi-Span® as its National Drug Code (NDC) validation source. This implementation will help ensure that the BCBSIL system is aligned with the system adopted by the Illinois Department of Healthcare and Family Services (HFS) to validate use of appropriate NDCs on Blue Cross Community OptionsSM, or BCBSIL Medicaid, claims. 

BCBSIL follows HFS billing guidance for outpatient services that relate to NDCs. A current list of services that require an NDC can be found on the HFS website.

If you are a BCBSIL independently contracted provider who submitted a BCBSIL Medicaid claim that was denied recently for invalid NDC, please resubmit your claim after validating that any NDC codes billed are appropriate for the services rendered and also active for the date(s) of service. 

This information is for educational purposes only. Providers are instructed to bill claims in accordance with BCBSIL and industry standards and based upon services rendered as documented in the medical record. 

Medi-Span is a registered trademark of Wolters Kluwer Clinical Drug Information, Inc.