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May 2019

Tips for billing medical drugs correctly

Medical billers often question how to bill appropriate quantities of National Drug Codes under the medical drug benefit. To ensure the payment you receive is accurate, submit the appropriate quantities for all NDCs.

Procedure code Billable units** Example dose HCPCS quantity (for dose example) NDC NDC billable unit** Correct NDC quantity (for dose example)
90633 N/A 0.5 ml 1 00006483141 ml ML0.5
90647 N/A 0.5 ml 1 00006489700 ml ML0.5
90651 N/A 0.5 ml 1 00006411903 ml ML0.5
90670 0.5 ml 0.5 ml 1 00005197102 ml ML0.5
90686 0.5 ml 0.5 ml 1 49281041850 ml ML0.5
90715 0.5 ml 0.5 ml 1 58160084252 ml ML0.5
90734 N/A 1 dose 1 49281058905 If powder or oral tablet, use UN. If liquid in a vial, use ML. ML0.5
90744 1 dose 0.5 ml 1 58160082052 ml ML0.5
J0585 1 unit 100 units 100 00023114501 UN UN1
J0641 0.5 mg 500 mg 1000 00781320194 If powder or oral tablet, use UN. If liquid in a vial, use ML. ML50
J0696 250 mg 250 mg 1 00409733701 If powder or oral tablet, use UN. If liquid in a vial, use ML. UN1
J1030 40 mg 40 mg 1 00009028003 ml ML1
J1040 80 mg 80 mg 1 00009030602 ml ML1
J1100 1 mg 1 mg 1 63323016505 ml ML0.25
J1745 10 mg 800 mg 80 57894003001 UN UN8
J1568 500 mg 40000 mg 80 68982085004 ml ML400
J1885 15 mg 60 mg 4 00409379601 ml ML2
J2357 5 mg 300 mg 60 50242021404 UN ML2
J3301 10 mg 80 mg 8 00003029328 ml ML2
J3420 1000 mcg 1000 mcg 1 00517003225 ml ML1
J9155 1 mg 240 mg 240 55566830301 UN UN3
J9155 1 mg 240 mg 240 55566840301 UN UN2
J9263 0.5 mg 600 mg 300 00781331570 If powder or oral tablet, use UN. If liquid in a vial, use ML. ML30
J9354 1 mg 160 mg 160 50242008701 UN UN1

About National Drug Code quantities and conversions

  • See the December 2018 Record for general guidelines for billing injectable drugs.
  • See the June 2016 Record for tips on how to calculate and bill NDC quantities and tips on billing electronically.
  • For information on a tool you can use to quickly and easily convert HCPCS or CPT units to NDC units, see the September 2017 Record.

**Billable units can be found on the Injections Minimum Fee Schedule on web-DENIS.
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