Mass Adjustment Notification Payment Integrity Program NDC

Blue Cross Blue Shield of North Dakota (BCBSND) wants to inform providers of a mass adjustment that will take place for claims that rejected incorrectly stating they had invalid National Drug Code (NDC) numbers.

Claims for certain drugs that were billed as component rather than with the NDC on the box were being incorrectly rejected through Payment Integrity Program review. The system was corrected on July 28, 2024; providers should not continue seeing this specific rejection.

This review and applicable adjustment(s) impacts claims processed between March 25, 2024, to July 28, 2024, for CPT codes 90471, 90679, 90698, 90744, 90750, 94640 and 96372. Please note, not all claims with these codes have been denied, only claims reviewed through the Payment Integrity Program review for this decision point.

The adjustments related to this recovery should be completed by October 8, 2024. We ask that providers with impacted claims wait to contact BCBSND for claim status updates until after this date.

Questions?
Contact the Provider Service Center phone number located on the back of the member’s ID card.