National Drug Code
A National Drug Code (NDC) is a unique three-segment identifier for a drug's labeler, product, and package size, used on claims to report the specific product dispensed.
Updated
A National Drug Code (NDC) is a unique, three-segment number that identifies a drug by labeler (the firm that manufactures or distributes it), product (the specific strength and formulation), and package (the size and type of the container). It is assigned to each listed drug and reported on claims where the specific product dispensed matters for payment.
On claims for drugs — particularly physician-administered drugs under medical benefit and pharmacy claims — the NDC identifies exactly which product was furnished, distinct from the HCPCS or NDC-related billing code that reports the service or category.
In practice
Because an NDC names one product among many that may bill under the same service code, the wrong NDC is a common cause of inaccurate payment on drug claims. Payers may require the NDC, its units, and the billing code to be internally consistent, and the format (5-4-2 or 5-3-2) must be reported as the payer expects.
Commonly confused with
- HCPCS Level II code: A HCPCS Level II code reports the category of drug or service billed; the NDC identifies the specific product within that category.