Rejection Message
NDC code [] is invalid. Procedure code <CPT> NDC code [] must be 11 digits.
Edit the procedure code under Settings > Codes > Find Procedure.
Find procedure code 'CPT' and edit the NDC and make sure it has 11 digits. Dashes (-) are ignored.
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Rejection Details
Tebra Validation Error
This rejection indicates the claim includes a procedure (CPT/HCPCS) code with an National Drug Code (NDC) number in the incorrect format.
Note: Since claims rejected within Tebra are not forwarded to the clearinghouse, timely filing cannot be generated for the submission until validation errors have been corrected and the claim resubmitted.
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Resolution
Follow the steps below to edit the National Drug Code (NDC) number in the Encounter record:
- Click Encounters > Track Claim Status. The Find Claim window opens.
- Look for and double click the appropriate claim to open. The Edit Claim window opens.
- Double click the Encounter ID number. The Edit Encounter window opens.
- Under the NDC column of the Procedures section, update the NDC number to the correct 11-digit number (excluding hyphens).
- If the NDC column is not displayed, customize the Procedures section to add the NDC column.
- If required by the payer, update or enter additional drug information related to the NDC number.
Note: When unsure, contact the payer to verify the required drug information to prevent further claim rejections.
- UC: Enter the unit count (e.g., if 1 vial is 1 mL, the UC is 1).
- UM: Enter the unit of measure (e.g., if 1 vial is 1 mL, the UM is ML).
Note: The MCG and MG qualifiers are only accepted on paper claims.
- Click Save & Rebill. Then, resubmit all affected claims when ready.
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- If the National Drug Code (NDC) number was entered in the Procedure record and needs to be edited, follow the steps below:
Note: Existing encounters with the procedure are not automatically updated when changes are made to the Procedure record. The changes are only applied when using the procedure moving forward.
- Find the procedure and double click to open. The Edit Procedure window opens.
- Under the Drug Information section, update the NDC Number to the correct 11-digit number (excluding hyphens).
- If required by the payer, update or enter additional drug information related to the NDC number.
Note: When unsure, contact the payer to verify the required drug information to prevent further claim rejections.
- Unit of measure: Click the drop-down arrow and select the appropriate unit of measure.
Note: The MCG and MG qualifiers are only accepted on paper claims.
- Unit count: Enter the unit count.
- Click Save. Log out and back into the Desktop Application (PM) to see the changes when using the procedure.
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