Billing with National Drug Codes (NDCs)
Note: For the most current information on Billing with National Drug Codes (NDCs), go to the Billing with National Drug Codes article posted on 2/01/2012 located in the News & Updates (View All) area of this website.
In May 2011, BCBSTX announced that claims submitted with an NDC will be reimbursed in accordance with the NDC schedule posted on the website under "Drugs" effective December 1, 2011. The effective date of this change has been postponed until January 1, 2012.
BCBSTX currently accepts NDC for billing of all physician administered and physician supplied drugs. Including the NDC on claims helps provide a more consistent pricing methodology for payment and will also facilitate better management of drug associated costs. Physicians are encouraged to begin including the NDC information on claims as soon as possible. For information about how to add the additional NDC and other required elements, please refer to the BCBSTX Provider website. BCBSTX will continue to accept the HCPCS or CPT code elements without NDC information (excluding unlisted or "Not Otherwise Classified" drugs). BCBSTX requires inclusion of the National Drug Code (NDC) along with the applicable Healthcare Common Procedure Coding System (HCPCS) or Current Procedural Terminology (CPT®) code(s) on claim submissions for unlisted or “Not Otherwise Classified” (NOC) physician administered and physician supplied drugs.