ICS KnowledgeBase

It seems that Medicaid and some other carriers are now requiring or going to require the NDC (National Drug Classification/Code) for the J codes used in billing. As a result, Sammy/SimpleSam has been updated to utilize and report these numbers on claims.

Preparation: The entry for the code in the procedure library has to be updated by the doctor. The JXXXXX code remains as always, but the description has to be exactly as follows: N5:0517493025 NAME OF DRUG HERE

The breakdown of that line is as follows:

First 2 Characters MUST be N5

The next character must be a colon :

The very next 10 or 11 characters must be the NDC number with numbers only and no dashes.

***NEIC requires that this field has a 11 digit number. If your NDC code is only 10 digits, you must enter a lead zero before the 10 digit code to make it 11.

After the NDC number, put a space.

After the space, put whatever you want for the description.

For example:  N5:00009028003 DEX PHO 4MG/CC

On paper claims, you will see the NDC number print as follows: N500009028003 immediately above the Date of Service for the line containing the J Code.

On electronic claims, although you cannot see it, it is in loop 2410, LIN segment, N5 qualifier and code inside the loop for the J Code