National Drug Code (NDC) Reporting Policy

The National Drug Code (NDC) is required to be billed on claim forms for drugs administered by physicians (including drugs for immunizations and radiopharmaceuticals), outpatient hospitals, and dialysis centers.

  • The NDC reported must be the exact NDC from the package or container from which the drug was administered.
  • NDCs must be reported even when MedStar Family Choice is the secondary or tertiary payor.

Claim denials

Claims for drugs will be denied if:

  • The NDC is missing or invalid,
  • The NDC Unit of Measure is missing or invalid; or
  • The NDC Quantity is missing.

When to report the NDC on CMS1500 and UB04 claim forms

  1. Physician-administered drugs:

    2.   When billing for drugs using J-code HCPCS, the following must be included:

    • The J-code HCPCS;
    • A valid 11-digit NDC; and
    • The quantity administered using the correct unit of measure.

      Exceptions: Physician-administered drugs for inpatient services, immunizations, and radiopharmaceuticals do not require this.

  1. Outpatient hospital and dialysis claims:

    2.   Hospitals (bill type 13X) and dialysis facilities (bill type 72X) must use NDCs when billing revenue codes 0250, 0251, 0252, 0257, 0258, and 0636.

      The claims must include:

    • A valid 11-digit NDC;

    • The associated drug-code HCPCS; and

    • The quantity administered using the correct unit of measure.


How to report the NDC for professional claims 

Electronic submission (837P):

  • Include the NDC in Loop 2410, data element LIN03 of the LIN segment.
  • The quantity goes in Loop 2410 CTP04, and the unit of measure (UOM) in Loop 2410 CTP05-01.
  • The unit price must be populated in Loop 2410 CTP03, though it may be entered as zero.

Paper submission (CMS1500):

  1. Enter the NDC, unit of measure, and quantity in the shaded area of box 24A.
  2. Use the qualifier "N4" followed by the 11-digit NDC (in the 5-4-2 format, no hyphens). If necessary, pad the NDC with zeros.
  3. Next, enter the two-character UOM qualifier, followed by the numeric quantity administered (limited to three decimal places).
  4. Whole numbers do not require a decimal point. For fractional units, the decimal must be included.

Sample NDC Reporting:

  • Whole Number: N412345678901UN1234567
  • Fractional Unit: N412345678901UN1234.567

Measurement Qualifiers for NDC Units:

  • F2: International Unit
  • GR: Gram
  • ML: Milliliter
  • UN: Units

How to report the NDC for facility claims

Electronic submission (837P):

  • Include the NDC in Loop 2410, data element LIN03 of the LIN segment.
  • Report the quantity in Loop 2410 CTP04, and the UOM in Loop 2410 CTP05-01.
  • The unit price must be populated in Loop 2410 CTP03 but can be zero.

Paper submission (CMS1500):

  1. Report the NDC qualifier "N4" in Field 43 (left justified).
  2. Enter the 11-digit NDC without hyphens, followed by the UOM qualifier and the quantity administered.
  3. Next, enter the two-character UOM qualifier, followed by the numeric quantity administered (limited to three decimal places).
  4. Whole numbers do not require a decimal, but fractional units must include the decimal point.

Reporting multiple NDCs on a facility claim

To report multiple NDCs on a single claim:

  • Each line item must reflect a valid NDC.
  • NDCs must be unique for each line item to avoid denials for duplicate claims.

For compound drugs, submit the following:


  1. Report the most expensive ingredient first, followed by other ingredients.
  2. For the first line, include the total units and total charges for all ingredients.
  3. For subsequent lines, list only the NDC and HCPCS code.
  4. If one line for a compound drug is denied, the entire compound drug will be denied.

Information current as of: