RC Claim Assist tool ensures correct billing units on medical drug codes

To help you bill claim units more easily, use the RC Claim Assist tool. It’s available to all contracted providers at no cost.

As electronic billing at the National Drug Code unit level becomes more of an industry standard, it’s still important that the HCPCS/CPT units align with the NDC units billed. RC Claim Assist can help you make quick and easy conversions from NDC dose to HCPCS or CPT units to help you correctly submit medical drug claims.

Steps to follow to complete a units conversion

1. Enter the NDC code.
2. Select the drug reimbursement code.
3. Select the unit of measure to convert by:
   • NDC pricing units
   • Administered dose
   • NDC package size
   • HCPCS/CPT code units
4. Enter the number administered.
5. View the NDC conversion summary report (see screenshot below).
6. View the average wholesale price, or AWP, displayed below the NDC billable units.

Tips to help you use the RC Claim Assist tool

• You can use any of these starting points to retrieve the conversion between HCPCS/CPT and NDC:
• HCPCS or CPT code
• NDC code
• Drug name
• Refer to the tool only as a general reference and in conjunction with other resources, such as applicable fee schedules.
• Note: AWP displayed is for reference only and doesn’t reflect the actual reimbursement in claims processing.

How do I access RC Claim Assist?
Go to the RC Claim Assist login page. You’ll register to use RC Claim Assist by following these steps:

• Enter your national provider identifier and click on Submit.
• Enter your first and last name.
• You’ll then be prompted to create a unique password.

You can find more information, including an instructional video, on the RC Claim Assist website under the About tab.

About National Drug Code quantities and conversions

• See the December 2018 Record for general guidelines for billing injectable drugs.
• See the May 2019 Record for tips on how to calculate and bill NDC quantities and tips on billing electronically.

For additional information on this tool so you can more quickly and easily convert HCPCS or CPT units to NDC units, see the September 2017 Record.