Others titles
- NDC and HCPCS Crosswalk
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
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.
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Description
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.
About this Dataset
Data Info
Date Created | 2014-01 |
---|---|
Last Modified | 2024-06-17 |
Version | 2024-06 |
Update Frequency |
Monthly |
Temporal Coverage |
N/A |
Spatial Coverage |
United States |
Source | John Snow Labs; Noridian Healthcare Solutions; |
Source License URL | |
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 |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
NDC | The 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. | string | - |
NDC_Mod | Healthcare Common Procedure Coding System (HCPCS) Level II codes may require the use of | string | - |
HCPCS | HCPCS 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. | string | - |
HCPCS_Mod | HCPCS 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. | string | - |
Relationship_Start_Date | The relationship start date between the NDC and HCPCS code. | date | - |
Relationship_End_Date | The relationship end date between the NDC and HCPCS code. | date | - |
HCPCS_Description | The long description of the HCPCS Level II code. | string | - |
NDC_Label | Product name given to the product by the manufacturer. Additional information on product may be provided. | string | - |
Number_of_Items_in_NDC_Package | The amount of product contained in the package as defined by the billing unit standard of the National Council for Prescription Drug Programs (NCPDP). | string | - |
NDC_Package_Measure | The total size of the package in volume or number of units contained. | string | - |
NDC_Package_Type | The container or package used for the drug product, i.e. vial, bottle, bag, etc. | string | - |
Route_of_Administration | Identifies the product’s intake or application method. | string | - |
Billing_Units | The unit of measure when billing NDC units. Provides the two-character abbreviation corresponding to valid units of measure per the NCPDP standard. | string | - |
HCPCS_Amount_1 | The amount of product in a HCPCS billing unit | number | level : Ratio |
HCPCS_Measure_1 | The number of HCPCS units in one NCPDP billing unit. | string | - |
CF | The Conversion Factor (CF) is the rate to convert HCPCS quantity to NDC quantity. This is derived by dividing the NDC amount by the HCPCS amount | number | level : Ratio |
Start_Date_1 | The Start Date #1 is the relationship start date between the NDC and HCPCS code. | date | - |
End_Date_1 | The End Date #1 is the relationship start date between the NDC and HCPCS code. | date | - |
Prior_Start_Date_2 | Prior Start Date. | date | - |
Prior_End_Date_2 | Prior End Date. | date | - |
Prior_Conversion_Factor_2 | Prior Conversion Factor. | number | level : Ratio |
Prior_Start_Date_3 | Prior Start Date. | date | - |
Prior_End_Date_3 | Prior End Date. | date | - |
Prior_Conversion_Factor_3 | Prior Conversion Factor. | number | level : Ratio |
Data Preview
NDC | NDC Mod | HCPCS | HCPCS Mod | Relationship Start Date | Relationship End Date | HCPCS Description | NDC Label | Number of Items in NDC Package | NDC Package Measure | NDC Package Type | Route of Administration | Billing Units | HCPCS Amount 1 | HCPCS Measure 1 | CF | Start Date 1 | End Date 1 | Prior Start Date 2 | Prior End Date 2 | Prior Conversion Factor 2 | Prior Start Date 3 | Prior End Date 3 | Prior Conversion Factor 3 |
00002-7335-11 | J2941 | 2006-03-01 | 2020-12-31 | INJECTION, SOMATROPIN, 1 MG | HUMATROPE (WITH STERILE DILUENT) 5 MG | 1.0 | EA | VL | SC | EA | 1.0 | MG | 5.0 | 2006-03-01 | 2020-12-31 | ||||||||
00002-7501-01 | J9201 | 2002-01-01 | 2018-12-31 | INJECTION, GEMCITABINE HYDROCHLORIDE, 200 MG | GEMZAR (VIAL) 200 MG | 1.0 | EA | VL | IV | EA | 200.0 | MG | 1.0 | 2002-01-01 | 2018-12-31 | ||||||||
00002-7502-01 | J9201 | 2002-01-01 | 2018-12-31 | INJECTION, GEMCITABINE HYDROCHLORIDE, 200 MG | GEMZAR (VIAL) 1 GM | 1.0 | EA | VL | IV | EA | 200.0 | MG | 5.0 | 2002-01-01 | 2018-12-31 | ||||||||
00002-7510-01 | J1817 | 2003-01-01 | INSULIN FOR ADMINISTRATION THROUGH DME (I.E., INSULIN PUMP) PER 50 UNITS | HUMALOG (VIAL) 100 U/ML | 10.0 | ML | VL | SC | ML | 50.0 | U | 2.0 | 2003-01-01 | ||||||||||
00002-7510-99 | J1817 | 1996-07-24 | INSULIN FOR ADMINISTRATION THROUGH DME (I.E., INSULIN PUMP) PER 50 UNITS | HUMALOG (VIAL) 100 U/1 ML | 10.0 | ML | VL | IJ | ML | 50.0 | U | 2.0 | 1996-07-24 | ||||||||||
00002-7511-01 | J1815 | 2003-01-01 | INJECTION, INSULIN, PER 5 UNITS | HUMALOG MIX 75/25 (VIAL) 75 U/ML-25 U/ML | 10.0 | ML | VL | SC | ML | 5.0 | U | 20.0 | 2003-01-01 | ||||||||||
00002-7511-99 | J1815 | 2007-12-07 | INJECTION, INSULIN, PER 5 UNITS | HUMALOG MIX 75/25 (VIAL) 75 U/1 ML-25 U/1 ML | 10.0 | ML | VL | SC | ML | 5.0 | U | 20.0 | 2007-12-07 | ||||||||||
00002-7512-01 | J1815 | 2006-11-01 | INJECTION, INSULIN, PER 5 UNITS | HUMALOG MIX 50/50 50 U/ML-50 U/ML | 10.0 | ML | VL | SC | ML | 5.0 | U | 2.0 | 2006-11-01 | ||||||||||
00002-7512-99 | J1815 | 2006-10-19 | INJECTION, INSULIN, PER 5 UNITS | HUMALOG MIX 50/50 50 U/1 ML-50 U/1 ML | 10.0 | ML | VL | SC | ML | 5.0 | U | 20.0 | 2006-10-19 | ||||||||||
00002-7516-59 | J1815 | 2003-01-01 | INJECTION, INSULIN, PER 5 UNITS | HUMALOG (CARTRIDGE) 100 U/ML | 3.0 | ML | CT | SC | ML | 5.0 | U | 20.0 | 2003-01-01 |