Guidance Regarding NDC’s on the CMS-1500 Form
Effective August 2008, Alabama Medicaid mandated that the
National Drug Code (NDC) number be included on the CMS-1500 claim form for the
Top 20 physician administered drugs as defined by CMS. Alabama Medicaid would
like to clarify the required format for the NDC number that is submitted on
this claim form. Medicaid requires that each submitted NDC contain 11-digits
(no dashes or spaces). The first 5-digits identify the labeler code of the
manufacturer of the drug. The next 4-digits identify the specific strength,
dosage form, and formulation of that drug. The last 2- digits identify the package size of the drug.
There may be some instances when an NDC does not contain all
eleven digits on the product’s container.
• xxxx-xxxx-xx; in this case a zero (0) would need to be
added in front of the first set of numbers.
Result: 0xxxxxxxxxx.
• xxxxx-xxx-xx: in this case a zero (0) would need to be
added in front of the second set of numbers.
Result: xxxxx0xxxxx.
• xxxxx-xxxx-x: in this case a zero (0) would need to be
added in front of the third set of numbers.
Result: xxxxxxxxx0x.
Please refer to the Food and Drug Administration (FDA)
website below for more
information regarding the National Drug Code,
http://www.fda.gov/cder/ndc/index.htm. For additional questions regarding the
CMS list of Top 20 physician administered drugs, please contact Pharmacy
Services at (334) 242-5050
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