Comments (5)
It seems that NDCs should always be normalized to the full 11 digits. The first 9 digits could then always be used for reporting without ambiguity.
from price-transparency-guide.
The rule indicates 10/11 byte NDC is required. "The NDC, in contrast, is a unique 10-digit or 11-digit
3-segment number, which provides a universal product identifier for drugs in the United States. The three segments of the NDC identify: The labeler (any firm that manufactures the drug); the product (specific strength, dosage form, and formulation of a drug); and the commercial package size and types" // re why not use RxCUI. Also: "plans and issuers may only use the NDC as the billing code type because, as discussed later in this preamble, the accuracy of pricing information for prescription drugs requires precise and specific product information, including package size and manufacturer.." Last in Definitions: "(xv) National Drug Code means the unique 10- or 11-digit 3-segment number assigned by the Food and Drug Administration, which provides a universal product identifier for drugs in the United States"
from price-transparency-guide.
Note on NDC from here, on page 65:
In the preamble to the HIPAA regulations,
HHS stated that it was adopting a uniform 11-digit
format to conform with customary practice used in
computer systems (65 FR 50314, 50329). (Aug. 17,
2000). The HIPAA 11-digit NDC format is
standardized such that the labeler code is always
5 digits, the product code is always 4 digits, and
the package code always 2 digits. To convert a 10-
digit NDC to an 11-digit HIPAA standard NDC, a
leading zero is added to the appropriate segment to
create the 11-digit configuration as defined above.
See 83 FR 38666 (Aug. 7, 2018).
from price-transparency-guide.
Is the consensus that we should follow the rule, which specifies 10 or 11 digit NDCs be used, and not the schema which calls for 8 digits and will cause confusion? Can someone from HHS please weigh in and provide clarification?
from price-transparency-guide.
If we do the reporting at the NDC 8 or 9 level, can CMS please establish standardized business rules to compute pricing if the pricing varies at the NDC 9 level?
What is every else doing in the absence of standardized business rules? Are you averaging out the AWP prices across all NDC11s that make up the NDC9 or are you dropping outliers that will skew the pricing and averaging out the majority at an NDC9 level? Any other ideas?
from price-transparency-guide.
Related Issues (20)
- Disjoint of version numbers between this site and the CMS Validator HOT 1
- Reading a Transparency File is NP Complete
- Cosmetic: wrong MS-DRG Grouper Version specified in In Network schema's billing_code_type_version "For example"
- MRF Validator - Schema file 'schema/schema.json' not found HOT 2
- Do allowed_amounts include the participants' cost? HOT 3
- In-network bundled code type enums
- How to display Tiered Networks HOT 1
- Update documentation for billing_code_type_version
- How did ya'll import the JSON files to SSMS? HOT 1
- Provider reference location link is not working in example file HOT 1
- How do I report BCBS non-compliance? HOT 11
- Reporting as files is poor design HOT 1
- Who to address an issue with unavailable files HOT 1
- Data from the provider Medica is partially not accessible HOT 1
- [deleted]
- Questions re: in_network schema
- CSTM-ALL descriptions are inconsistent
- Errors during Cigna file processing HOT 2
- Aetna Allowed Amounts Issue HOT 1
- HPT Online Validator HOT 1
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from price-transparency-guide.