Keywords

  • NDC to HCPCS Crosswalk
  • 2016 NDC/HCPCS Crosswalk
  • NDC Conversion Factor Changes
  • HCPCS Conversion Factor Changes
  • HCPCS CrossWalk
  • NDC CrossWalk

National Drug Code HCPCS Crosswalk

$79 / year

The National Drug Code / Healthcare Common Procedure Coding System (NDC/HCPCS) crosswalk file provides a list of National Drug Codes (NDC) that are assigned to a Level II HCPCS along with conversion factors that are used to price the applicable billings to allow processing of claims filed using the National Council for Prescription Drug Programs (NCPDP) format.

Complexity

The National Drug Code / Healthcare Common Procedure Coding System (NDC/HCPCS) crosswalk file provides a list of National Drug Codes (NDC) that are assigned to a Level II HCPCS along with conversion factors that are used to price the applicable billings to allow processing of claims filed using the National Council for Prescription Drug Programs (NCPDP) format.
The Pricing, Data Analysis and Coding (PDAC) updates the file monthly to add, revise or delete NDCs as published by Redbook. The file provides all prior updates, along with details on the changes that occurred in that month.
The PDAC only adds and updates the NDC/HCPCS that are billable to the Durable Medical Equipment Medicare Administrative Contractor (DMEMACs). Prior to the effective PDAC contract date of August 2008, all NDCs were updated. While these are still listed on the crosswalk file, they are not updated as changes are reported in Redbook.

Date Created

2014-01

Last Modified

2018-10-20

Version

2018-10

Update Frequency

Monthly

Temporal Coverage

N/A

Spatial Coverage

United States

Source

John Snow Labs => Noridian Healthcare Solutions

Source License URL

John Snow Labs Standard License

Source License Requirements

N/A

Source Citation

N/A

Keywords

NDC to HCPCS Crosswalk, 2016 NDC/HCPCS Crosswalk, NDC Conversion Factor Changes, HCPCS Conversion Factor Changes, HCPCS CrossWalk, NDC CrossWalk

Other Titles

NDC and HCPCS Crosswalk

Name Description Type Constraints
NDCThe National Drug Code (NDC) serves as a universal product identifier for human drugs and biologics. Each NDC must be reported as an 11-digit code unique to the manufacturer of the specific drug or product.stringrequired : 1
NDC_ModHealthcare Common Procedure Coding System (HCPCS) Level II codes may require the use ofstringmaxLength : 2
HCPCSHCPCS codes are used by Medicare and monitored by the CMS. HCPCS Level II codes are assigned to every service a medical practitioner provides to a Medicare patient including durable medical equipment, prosthetics and orthotics supplies. These codes are an alpha character followed by four numbers.stringrequired : 1 maxLength : 5
HCPCS_ModHCPCS Level II codes may require the use of modifiers to capture the exact nature of the service. The Level II modifiers are two alphabetic or alphanumeric digits.stringmaxLength : 2
Relationship_Start_DateThe relationship start date between the NDC and HCPCS code.daterequired : 1
Relationship_End_DateThe relationship end date between the NDC and HCPCS code.date-
HCPCS_DescriptionThe long description of the HCPCS Level II code.stringrequired : 1
NDC_LabelProduct name given to the product by the manufacturer. Additional information on product may be provided.stringrequired : 1
Number_of_Items_in_NDC_PackageThe amount of product contained in the package as defined by the billing unit standard of the National Council for Prescription Drug Programs (NCPDP).stringrequired : 1
NDC_Package_MeasureThe total size of the package in volume or number of units contained.stringrequired : 1
NDC_Package_TypeThe container or package used for the drug product, i.e. vial, bottle, bag, etc.string-
Route_of_AdministrationIdentifies the product’s intake or application method.string-
Billing_UnitsThe unit of measure when billing NDC units. Provides the two-character abbreviation corresponding to valid units of measure per the NCPDP standard.stringrequired : 1 maxLength : 2
HCPCS_Amount_1The amount of product in a HCPCS billing unitnumberrequired : 1 level : Ratio
HCPCS_Measure_1The number of HCPCS units in one NCPDP billing unit.stringrequired : 1
CFThe Conversion Factor (CF) is the rate to convert HCPCS quantity to NDC quantity. This is derived by dividing the NDC amount by the HCPCS amountnumberrequired : 1 level : Ratio
Start_Date_1The Start Date #1 is the relationship start date between the NDC and HCPCS code.daterequired : 1
End_Date_1The End Date #1 is the relationship start date between the NDC and HCPCS code.date-
Prior_Start_Date_2Prior Start Date.date-
Prior_End_Date_2Prior End Date.date-
Prior_Conversion_Factor_2Prior Conversion Factor.numberlevel : Ratio
Prior_Start_Date_3Prior Start Date.date-
Prior_End_Date_3Prior End Date.date-
Prior_Conversion_Factor_3Prior Conversion Factor.numberlevel : Ratio
NDCNDC_ModHCPCSHCPCS_ModRelationship_Start_DateRelationship_End_DateHCPCS_DescriptionNDC_LabelNumber_of_Items_in_NDC_PackageNDC_Package_MeasureNDC_Package_TypeRoute_of_AdministrationBilling_UnitsHCPCS_Amount_1HCPCS_Measure_1CFStart_Date_1End_Date_1Prior_Start_Date_2Prior_End_Date_2Prior_Conversion_Factor_2Prior_Start_Date_3Prior_End_Date_3Prior_Conversion_Factor_3
63459-0391-20J34902008-03-31UNCLASSIFIED DRUGSTREANDA1.0EAVLIVEA1.0EA1.02008-03-31
51927-1194-00J34902003-09-08UNCLASSIFIED DRUGSBENZOCAINE1.0EAJRGM1.0EA1.02003-09-08
62991-1352-02J34902007-01-01UNCLASSIFIED DRUGSHYALURONIC ACID1.0EAGM1.0EA1.02007-01-01
54868-5348-01None2006-04-13TEMODAR, 5 MG, ORALTEMODAR 5 MG5.0EABOPOEA5.0MG1.02006-04-13
00085-3004-03None2012-12-05TEMODAR, 5 MG, ORALTEMODAR, 5 MG5.0EABXPOEA5.0MG1.02012-12-05
62991-1352-01J34902007-01-01UNCLASSIFIED DRUGSHYALURONIC ACID1.0EABOGM1.0EA1.02007-01-01
62991-1352-04J34902007-01-01UNCLASSIFIED DRUGSHYALURONIC ACID1.0EABOGM1.0EA1.02007-01-01
00008-0923-55J34902004-05-18UNCLASSIFIED DRUGSPROTONIX 40 MG1.0EAVLIVEA1.0EA1.02004-05-18
00085-3004-04None2012-12-05TEMODAR, 5 MG, ORALTEMODAR, 5 MG14.0EABXPOEA5.0MG1.02012-12-05
63323-0385-10J34902007-08-13UNCLASSIFIED DRUGSCEFOTETAN 1 GM1.0EAVLIJEA1.0EA1.02007-08-13