NDC box vs vial

LlawtherLlawther
in DENIALS & APPEALS

Hello- is anyone else having issue with specific payers (HMK) requesting the box NDC vs vial NDC. Our policy has been that clinicians scan what is being administered which is the vial. We are getting denials stating they require the box NDC, our IT department states it is not possible to create an NDC based on payer preference for box vs vial. We have found that the drugs in question are status N, we do not expect additional payments on the drug.

thank you,

Lori

Comments

  • lluczek61lluczek61

    Our organization is having a similar issue with Humana. We are currently following up with Humana provider rep. The Humana policies on their website do not state they require the NDC from the box; but they are denying if we report the NDC from the vial.

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