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Change in Reporting National Drug Codes (NDCs) for Outpatient Expensive Drugs and Renal Dialysis Injectable Drugs Effective March 1, 2013

Illinois Medicaid - HFS·IL · Nephrology, Oncology·Provider Notice
Effective date
Mar 1, 2013
We identified it
Jun 20, 2026
Days to comply

Summary

Effective March 1, 2013, providers must report detailed revenue code line information when billing multiple NDCs for the same HCPCS code for outpatient expensive drugs and renal dialysis injectable drugs. Each NDC must be reported on separate revenue code lines with individual charges and units, and 340B purchased drugs must include modifier UD.

Action Required

Action needed
By March 1, 2013: Billing team must update claim submission processes to report each NDC on separate revenue code lines (0634, 0635, 0636) with individual charges and units instead of rolling them into the first line. Add modifier UD as the first modifier for all 340B purchased drugs. Update billing software to ensure detailed reporting requirements are met for expensive drugs and renal dialysis injectable drugs. Claims not following the new format may be rejected.

Affected Billing Codes

Q4081
J2501