What is a National Drug Code (NDC)? The NDC, or National Drug Code, is a unique 10-digit or 11-digit, 3-segment number, and a universal product identifier for human drugs in the United States. The 3 segments of the NDC identify: the labeler, the product, and the commercial package size.
Below are some key take-aways for pharmacies to be aware of to ensure compliance:
The new codes are for describing the infusion of tixagevimab and cilgavimab monoclonal antibody (code XW023X7), and the infusion of other new technology monoclonal antibody (code XW023Y7).
Used for medical claim reporting in all healthcare settings, ICD-10-CM is a standardized classification system of diagnosis codes that represent conditions and diseases, related health problems, abnormal findings, signs and symptoms, injuries, external causes of injuries and diseases, and social circumstances.
The clinical syndrome of any 'drug overdose' is typically represented by two broad ranges of codes within the ICD-10; “T36 to T50 Poisoning by drugs, medicaments and biological substances” ('T-codes') and “F10 to F19 Mental and behavioural disorders due to psychoactive substance use” ('F-codes').
T50.902AT50. 902A - Poisoning by unspecified drugs, medicaments and biological substances, intentional self-harm [initial encounter] | ICD-10-CM.
Codes for underlying cause of overdose death include the letter X or Y (for example, X40: accidental poisoning, X60: intentional self-harm). Codes for opioid-related contributing cause of overdose death include a T (for example., T40.
Substance use disorders and ICD-10-CM codingMental and Behavioral Disorders due to...Code1...use of opioidsF11...use of cannabisF12...use of sedatives, hypnotics, anxiolyticsF13...use of cocaineF146 more rows•Sep 10, 2015
Using a population-based, hospitalization database, we determined that the principal diagnostic codes for acetaminophen overdose (ICD-9-CM, 965.4; ICD-10, T39.
Poisoning by other opioids, accidental (unintentional), initial encounter. T40. 2X1A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM T40.
For underdosing, assign the code from categories T36–T50 (fifth or sixth character "6"). Codes for underdosing should never be assigned as principal or first-listed codes.
Medication underdosing occurs when a physician writes a prescription for a lower dose than clinically indicated. One common example of unintentional underdosing is when an antibiotic is administered at a reduced or “renal dose” for a patient who has acute kidney injury.
The drug giving rise to the adverse effect should be identified by use of codes from categories T36-T50#N#ICD-10-CM Range T36-T50#N#Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances#N#Code First#N#, for adverse effects, the nature of the adverse effect, such as:#N#adverse effect NOS ( T88.7)#N#aspirin gastritis ( K29.-)#N#blood disorders ( D56 - D76)#N#contact dermatitis ( L23 - L25)#N#dermatitis due to substances taken internally ( L27.-)#N#nephropathy ( N14.0- N14.2)#N#Includes#N#adverse effect of correct substance properly administered#N#poisoning by overdose of substance#N#poisoning by wrong substance given or taken in error#N#underdosing by (inadvertently) (deliberately) taking less substance than prescribed or instructed#N#Note#N#The drug giving rise to the adverse effect should be identified by use of codes from categories T36-T50 with fifth or sixth character 5.#N#Type 1 Excludes#N#toxic reaction to local anesthesia in pregnancy ( O29.3-)#N#Type 2 Excludes#N#abuse and dependence of psychoactive substances ( F10-F19)#N#abuse of non-dependence-producing substances ( F55.-)#N#immunodeficiency due to drugs ( D84.821)#N#drug reaction and poisoning affecting newborn ( P00-P96)#N#pathological drug intoxication (inebriation) ( F10-F19)#N#Use Additional#N#code (s) to specify:#N#manifestations of poisoning#N#underdosing or failure in dosage during medical and surgical care ( Y63.6, Y63.8- Y63.9)#N#underdosing of medication regimen ( Z91.12-, Z91.13-)#N#T36 Poisoning by, adverse effect of and unde...#N#T37 Poisoning by, adverse effect of and unde...#N#T38 Poisoning by, adverse effect of and unde...#N#T39 Poisoning by, adverse effect of and unde...#N#T40 Poisoning by, adverse effect of and unde...#N#T41 Poisoning by, adverse effect of and unde...#N#T42 Poisoning by, adverse effect of and unde...#N#T43 Poisoning by, adverse effect of and unde...#N#T44 Poisoning by, adverse effect of and unde...#N#T45 Poisoning by, adverse effect of and unde...#N#T46 Poisoning by, adverse effect of and unde...#N#T47 Poisoning by, adverse effect of and unde...#N#T48 Poisoning by, adverse effect of and unde...#N#T49 Poisoning by, adverse effect of and unde...#N#T50 Poisoning by, adverse effect of and unde...#N#with fifth or sixth character 5.
T48 Poisoning by, adverse effect of and underdosing of agents primarily acting on smooth and skeletal muscles and the respiratory system. T49 Poisoning by, adverse effect of and underdosing of topical agents primarily affecting skin and mucous membrane and by ophthalmological, otorhinorlaryngological and dental drugs.
In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere.". Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code.