On Wednesday, December 21, 2011, Medicare FFS turned off the current ASC X12 Version 5010 Common Edit and Enhancements Module (CEM) National Drug Code (NDC) validation edit for Medicare Part A. The specific NDC edit being turned off requires that the NDC in Loop ID 2410 LIN03 to be validated against the Food and Drug Administration's (FDA) NDC code list. A replacement NDC edit will be implemented in the Part A CEM for the January 2012 Shared System Quarterly release which will perform syntactical editing only of the NDC submitted in Loop ID 2410 LIN03.
A similar announcement was disseminated for the deactivation of the Part B NDC edit on Monday, December 19, 2011. The Medicare Part B NDC edit was deactivated on Friday, December 9, 2011. NDC Code Background: The NDC is a unique product identifier used for drugs intended for human use and is used for reporting prescribed drugs and biologics when required by government regulation, or as deemed by the provider to enhance claim reporting or adjudication processes. The Drug Listing Act of 1972 requires registered drug establishments to provide the FDA with a current list of all drugs manufactured, prepared, propagated, compounded, or processed by it for commercial distribution. Drug products are identified and reported using the NDC. The NDC is a unique number expressed in 3-sections. This numeric identifier is assigned to each medication listed under Section 510 of the US Federal Food, Drug, and Cosmetic Act. The sections identify the labeler or vendor, the product (within the scope of the labeler), and the type of package (of this product). The ASC X12 TR3 documents stipulate that the 5-4-2 expression of NDC values must be used. However, the FDA does not have a version of the NDC in this (5-4-2) format. Therefore, CMS has created a version of the NDC in the 11-byte numeric NDC derivative, which pads the product code (4 positions) or package code (2 positions) sections of the NDC with a leading zero thus resulting in a fixed length 5-4-2 configuration. ____________________________________________________________________________________________________________________________________________________________________________________________ It's a Busy Time of Year. Make each office visit an opportunity to talk with your patients about the importance of getting the seasonal flu vaccination and a one-time pneumococcal vaccination. Remember, Medicare pays for these vaccinations for all beneficiaries with no co-pay or deductible. The seasonal flu and invasive pneumococcal disease kill thousands of people in the United States each year, most of them 65 years of age and older. The Centers for Disease Control and Prevention (CDC) also recommends that healthcare workers and caregivers be vaccinated against the seasonal flu. Protect your patients. Protect your family. Protect yourself. Get the Flu Vaccine-Not the Flu. Remember - The flu vaccine plus its administration are covered Part B benefits. CMS has posted the 2011-2012 seasonal flu vaccine payment limits at http://www.CMS.gov/McrPartBDrugAvgSalesPrice/10_VaccinesPricing.asp. Note that the flu vaccine is NOT a Part D-covered drug. For more information on coverage and billing of the flu vaccine and its administration, as well as related educational provider resources, visit http://www.CMS.gov/MLNProducts/35_PreventiveServices.asp and http://www.cms.gov/immunizations. Note: If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser. If you know someone who would like to subscribe to a Medicare Fee-For-Service (FFS) provider listserv, go to (http://www.cms.gov/prospmedicarefeesvcpmtgen/downloads/Provider_Listservs.pdf). If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/wa.exe?INDEX) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.gov/ContactCMS). Thank you.
