NDC Numbers For Radiopharmaceuticals

Question:
My facility tells me I need to submit NDC numbers for radiopharmaceutical doses. How do I find these, and are these to replace the A codes?

Answer:

National Drug Codes (NDC) are often requested by Medicaid or third party payers as unique identifiers for drugs and radiopharmaceuticals. NDC codes can be obtained in several locations. We suggest that you first check with the supplier of your radiopharmaceutical(s) as they should have the specific product and manufacturer specific NDC code(s) for the products you purchase. A second source is the RedBook published by Truven information obtained at URL http://truvenhealth.com/products/micromedex/product-suites/clinical-knowledge/red-book. A third source is the following URL, https://www.accessdata.fda.gov/scripts/cder/ndc/default.cfm.

Finally, the SNMMI lists NDC numbers in some of our Q&As when provided by a manufacturer and typically when a radiopharmaceutical is new as a service for our membership. When reporting HCPCS code A4641, A9599 or A9699, be sure to include the 11 digit NDC on the claim form. Of note, when looking up NDC numbers often the listing will not provide all 11 digits and leading or following zeros may be needed to get to the payer required 11 digits, if you have questions regarding where these additional zeros are placed, contact the manufacturer of the radiopharmaceutical.

NDCs are not supposed to replace A codes. They are used to provide an additional level of identification for drugs and radiopharmaceuticals.

The opinions referenced are those of the members of the SNMMI Coding and Reimbursement Committee and their consultants based on their coding experience. They are based on the commonly used codes in Nuclear Medicine, which are not all inclusive. Always check with your local insurance carriers as policies vary by region. The final decision for the coding of a procedure must be made by the physician considering regulations of insurance carriers and any local, state or federal laws that apply to the physicians practice. The SNMMI and its representatives disclaim any liability arising from the use of these opinions.