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Adding NDC Numbers to Claims

This documentation will help you add NDC (National Drug Code) numbers to your claims in MacPractice.

NDC - Medications Set-Up
Some carriers might require you to submit a drug's NDC numbers on claims.

On a paper claim, this information will print in Box 24 on the CMS 1500 in the gray line above your procedure information. In order to have NDC numbers appear on your claims, you will need to have a prescription associated to the patient. First, you will want to be sure the drug and NDC already are entered into MacPractice.

Go to References and select either Medications (FDB) or Medications (Custom) from the sidebar. Once you have added your drug in the Detail tab, you will want to enter the NDC number on the Dose tab if on the FDB reference, or in the Detail tab if on the Custom reference.

Medications (FDB)
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Medications (Custom)
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You will most likely want to create multiple medication references for each NDC number, since the number is different depending on the dosage and packaging information. 

NDC - Associating Medications to a Patient
Once you have created a drug in MacPractice, it needs to be associated to a patient. This can be done in one of three ways. You can add the drug to the patient at the time of entering charges or you can add it to the patient using the Rx ability and associate it to the charges later. You can also associate a Medication to a fee in the fee schedule.

Adding a Medication Using the Rx Ability
To add a medication to a patient before entering charges, click on the Rx ability. You will see that drugs or Medications need to be associated to a patient and an incident. To add a drug to a patient, click the green Plus button to create a new record. If you do not have a patient selected, you will be prompted to select one. The sidebar will say New Record until you have saved the drug.
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The NDC number will pull from the Medication reference into the National Drug Code field. If it does not, you can also click the Search icon in the National Drug Code field to select an NDC umber.

Press Command + S to save. You can add as many drugs as you need per incident. However, if you need to use the exact same NDC number more than once, you only need to associate the drug once per incident. The drug now needs to be associated to the charge in the ledger. Return to the ledger, open a new charge window and add your procedure code. You can then associate the drug to the code in the Rx tab.
 
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If you click the green Plus button, you will see the drugs associated to the incident that you are on. Keep in mind you can only associate one drug per procedure code. Select your drug.

The drug now appears under the Rx tab in the charge window.


Save the charge. Now all you need to do is create the claim. Select the charges, then go to the Print pop-up menu and select Create Insurance Claim. You will see the NDC number above the procedure line in box 24 on a paper claim. There will be an N4 qualifier before the number. This is the qualifier code designating this number as an NDC number.


If you submit claims electronically, you will see the NDC code in the procedure information of the claim. Go to eClaims, click on the claim and twist down Procedure. Continue to scroll down until you see the NDC field.



Adding a Medication from Charge Window
You do not necessarily need medications associated to a patient before creating charges. This also can be done as you are entering charges. It still is recommended, however, that you create your Medications in the References ability with your NDC numbers first.
To add a Medication from the New Charge Window, go to the ledger, open the charge window and select your charge. Go to the Rx tab and click the green Plus button.
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You will see new record appear in the window because there are no medications associated to this patient yet. Click on the green Plus button to select your medications.

After selecting the medication, click Create. The medication is associated to the patient in the Rx ability and to the charge at the same time. Now the drug appears under the Rx tab in the charge window.


Save the charge. Now you need to create a claim. Select the charges, then go to the Print pop-up menu and select Create Insurance Claim. You will see the NDC number above the procedure line in box 24 on a paper claim. There will be an N4 qualifier before the number. This is the qualifier code designating this number as an NDC number.


If you submit claims electronically, you will see the NDC code in the procedure information of the claim. Go to eClaims, click on the claim and twist down Procedure. Continue to scroll down until you see the NDC field.



Associating a Medication to a Fee
If your fee always uses the same medication with the same NDC number, you can also associate Medications in your Fee Schedule. You will want to make sure you have your Medications References set up properly. See Medications Reference for more information. Go to your Fee Schedules by clicking on the References Ability and selecting Fee Schedules in the sidebar. Select the appropriate Fee Schedule and Fee.


With the correct fee selected, click on the Specialty tab. You will see an area for Medications. Click on the green Plus button to associate a Medication to the fee. You will only be able to associate one Medication per fee. If you use multiple NDC numbers for one procedure, for example if you get the drug from more than one supplier, you will most likely want to create separate fees in the fee schedule with different aliases. Once the Medication is associated to the fee, and you enter the procedure code in the charge window, you will see the Medication associated to the charge and the patient in the Rx tab.

A Note About Changing Records
Please note that if you make changes to the Medication reference or to the patient's Rx information, it will change in the charge as well. If you make changes to this reference and need to re-create or rebuild the old claim, then the NDC number will change there as well. You should instead be associating separate drug references for each different drug and not making changes to a previously used record. If the NDC and drug are exactly the same and you need to use them more than once, then you do not need to associate another drug and can instead select the same drug more than once in the charge window.

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