Reading an NDC
- 10 digits on the box, 11 on the claim. Package NDCs are printed 4-4-2, 5-3-2 or 5-4-1. Claims use 11 digits (5-4-2): add a leading zero to the short part. Enter the NDC with its hyphens; without them, a 10-digit NDC can match more than one product.
- NDC units aren't HCPCS units. The claim line is billed in HCPCS units (for J0897, 1 unit = 1 mg); the NDC is reported with its own unit of measure (UN, ML, GR or F2) and quantity.
- In the billing system, enter the 11 digits without hyphens (e.g.
55513071001) with the NDC unit of measure and quantity your payer asks for.
Drug codes, units and prices are from the CMS NDC-HCPCS crosswalk and Medicare Part B payment limits (quarterly); vaccine codes from the CDC IIS code sets (weekly); strength, package, NDC unit and quantity and FDA status from the FDA NDC Directory (weekly). For a dose calculator use the drug pricing lookup; for registry reporting the vaccine code lookup. CPT is a registered trademark of the American Medical Association; CPT descriptions aren't shown.