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Physician-Administered Drugs and National Drug Code Billing Requirement

June 06, 2011

When billing for physician-administered drugs (J-codes and HCPCS codes) administered in the office setting or outpatient hospital, CareOregon will continue to accept claims when the (11 digit identifier) NDC is missing for dates of service prior to July 1, 2011. For codes administered on and after July 1, the NDC will be required in order for claims to be considered for payment.
 
Please go to the Division of Medical Assistance Programs (DMAP) web page for instructions and examples on how to submit claims for both paper and electronic formats.

If you are interested in attending a NDC Billing Training, please click here.

If you have questions, please contact the CareOregon Customer Service Department at 503-416-4100 or 1-800-224-4840, Monday through Friday, 8 a.m. to 5 p.m. TTY/TDD users should call
1-800-735-2900.

Billing resources:

Department of Human Services - Frequently asked questions and billing information

NDC Helpful Billing Tips

Additional resources:

Medicaid Drug Rebate Program

Federal Drug Administration – NDC directory

340B Drug Program