Formatting of NDC Codes in Medical and Pharmacy Claims
NDC drug codes consist of three parts:
[labeler]-[product code]-[package code]
The number of digits for each part is not fixed:
The 10-digit NDC will be in one of the following configurations: 4-4-2, 5-3-2, or 5-4-1, meaning that there are 4 or 5 digits for the labeler code, 4 or 3 digits for the product code and 2 or 1 digit(s) for the package code.
Note that FDA proposed a new 12-digit, 6-4-2 format for NDC, but it is not yet in place.
Per X12 EDI and NCPDP standards, NDC numbers used on healthcare claims and related transactions must be formatted as digits only, without delimiters. Each NDC number must be exactly 11 digits, which is accomplished by adding leading zeros (left-padding with zeros) to each NDC component.
To be able to look up an NDC number from a claim (e.g., using the NDC directory) we have to get rid of the leading zero:
- From the labeler, if it is five characters with the leading zero, or
- From the product code, if it is four characters with the leading zero, or
- From the package code, if it is two characters with the leading zero
The resulting code must be in one of the allowed formats: 4-4-2, 5-3-2, or 5-4-1. Note you only need to make one of these changes.
Instead of doing it manually, you can use our code lookup tool. Select Drug from the drop-down and enter the first nine characters of the NDC from your claim.
|NDC 11 Digits from Claim||Link to the Lookup Tool||NDC in Canonical Form|