Drug billing is one of the highest audit-risk areas in ophthalmology.
๐น What is an NDC Code?
NDC (National Drug Code) identifies:
- Manufacturer
- Drug
- Package size
๐น Why NDC is Important
- Required by most payers
- Ensures accurate reimbursement
- Prevents claim rejection
๐น NDC Format
- Must be 11-digit format
- Example: 12345-6789-01
๐น Units Billing
๐ Always match:
- HCPCS units
- Actual dosage administered
๐น Example
If drug = 2 mg per unit
And given = 4 mg
๐ Bill = 2 units
๐น Common Errors
- Wrong unit conversion
- Missing NDC
- Using package units instead of administered units
