Reporting of NDC #/ Data

[adam holbrook]

Hello all.  Is anyone reporting NDC numbers, Billing units and Qty to your insurance companies?  Just wondering if you have any pearls before I consider applying the update to our live system.  Have you noticed any changes in reimbursement?  I don't see how they could make much sense of the data that they receive in the format that they decided on.  Our billing Dept is pushing for the change here as according to them more Ins companies are requesting the information.  I'm in Ohio and I'm not sure that it is required here yet for Medicare/ medicaide.  I'm not sure how knowledgeable they are as far as what is required to report.  They (billers) are asking for NDC# for everything (NDC #'s only) which doesn't make sense to me and McKesson will only report NDC info for items that have CPT codes. For Procrit that is dosed in Units are you reporting it as units (F2) or ML? The system seems to want to use ML as this is the package type.  Are you reporting premixed ABX as ML, but ABX vials as UN even though they get added to a bag? This is quite a mess.  Thanks for any help you may be able to provide. Adam

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[Brookins, Leslie]

Hi Adam

 

We completed a spreadsheet and had McKesson populate it as part of our 8.1 SP7 upgrade in 2008.  There is now (starting in version 8.7 I think) a button on the Facility Configuration, Charging tab that says "Populate NDC Measure Values" that can be used for this.  You have to be careful though.. if you've changed any Pkg Qty & Measure fields in Master Inventory, it will not auto-populate correctly.  In those cases you have to review each one manually and in most cases enter a factor so this will calculate correctly. 

 

For Procrit, the measure would be ML.  For Antibiotics that come as a powder, the measure would be UN.   If you have changed HMM to calculate these as ML, you have to enter an NDC factor so that your 10mL (for example) is converted to 1 UN.

 

In general, meds that come in solid form (tablets, capsules) and injectables that come in powder vials have NDC measure UN.  Meds that come in liquid form including liquid injectables have NDC measure ML.  Topical meds have NDC measure GM.

 

There is an NDC crosswalk that you can use for reference at the link below.  This only includes meds with HCPCS.

https://www.dmepdac.com/crosswalk/index.html

 

Missouri requires NDC reporting for all meds (not just meds with HCPCS).  In HMM 8.1 SP7, HMM required that you have a HCPCS code (alternate item number) entered in facility inventory or it would not allow you to populate the NDC measure fields.  To get around this, we entered a fake HCPCS code (RXNDC) in HMM then stripped it in the interface engine.  HMM 8.7 and 10.1 do not require this.

 

I'm attaching an example of this billing and a charging overview presentation that Cathy Hafner did.  It has a section about NDC billing. 

 

Hope this helps.  Please let me know if you have other questions.

 

 

 

 

 

 

 

Thanks,
Leslie
816-932-3927

 

 

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From: mckesson-automation...@googlegroups.com [mailto:mckesson-automation...@googlegroups.com] On Behalf Of adam holbrook
Sent: Thursday, February 10, 2011 10:09 AM
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Subject: Reporting of NDC #/ Data

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[Aadnes, Sam]

Adam,

We are on HMM 8.6.5 and there is a setting on the lower right that says ‘Allow NDC Measure without and Alternate Item Number’.  With that checked, you do not need to enter the alternate.  The automatic population function is there also as described below by Leslie.  We used the auto populate but I had some reports written to identify the drugs that needed correction.

Sam

 

 

Samuel Aadnes, PharmD

Information Systems Pharmacist

(701) 530-6921

Beeper: 1160

sdaa...@primecare.org

 

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[adam holbrook]

Thanks for the help guys.  I'm on HMM Version 8.1 SP8 Hotfix 1 build 6.  Thanks for pointing out the allow NDC feature.  I contacted McKesson support for assistance and they didn't point this out and it wasn't in the helpful hints guide that they sent me regarding NDC reporting.  I guess it is an outdated file.  I'll have to see if our billing dept can be more specific about who is requesting the data and what it is they require to report. It is possible that I won't have to worry about the NDC measure and Qty fields yet.  In my version of HMM there is a field on the facility inventory, Dispensing tab that is for an override billing NDC number which is where I though you would plug in a real NDC number for those items that have facility generated (fake) NDC numbers, but I can't get an NDC # to hold in this field.  When I finish updating it just blows out.  Any ideas? Have you had any reimbursement issues after go live of this?  I was wondering what would happen if you send an obsolete (or bogus) NDC #  ?  Thanks, Adam --- On Thu, 2/10/11, Aadnes, Sam <sdaa...@primecare.org> wrote:

[Brookins, Leslie]

Hi Adam -

 

We use the override billing NDC number successfully.  We are on a diff version though (10.1.0.1) so not sure if that is a specific issue with your version.  We also used on 8.1 SP7. 

 

We haven't had any reimbursement issues.  If we send a bad NDC, it gets sent back through the financial department somehow and they contact us for the correct one.

 

Thanks,
Leslie
816-932-3927

 

 

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From: mckesson-automation...@googlegroups.com [mailto:mckesson-automation...@googlegroups.com] On Behalf Of adam holbrook

Sent: Friday, February 11, 2011 6:42 AM

[Aadnes, Sam]

Adam,

We use that function also and have not had any trouble with this.  I am not sure if there is a setting that controls this or not but I know that we did not have this feature until we upgraded to 8.6.5.  If I type a number in that field it automatically prompts me if that NDC is not in the FDB table.  We use this for local items and for NDC numbers that are not in FDB at the time that we have entered them.

Thanks,

 

Samuel Aadnes, PharmD

Information Systems Pharmacist

(701) 530-6921

Beeper: 1160

sdaa...@primecare.org