Coding

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Saturday, May 31, 2003

WASHINGTON — Medicare has postponed indefinitely the transition from HCPCS to the National Drug Coding (NDC) system.

Various DMERC publications had informed providers that they must drop HCPCS and use National Drug Codes (NDC) as part of HIPAA beginning April 1. However, the billing method proved too difficult to connect with Medicare’s current HCPCS and nearly impossible to create a system that would protect against fraud.

“It’s quite a nightmare,” said Mickey Letson, chairman of the Respiratory Homecare Providers Association, regarding the attempt to switch over to an NDC system. “A multi-step process would have to take place. Then, fraud and abuse would create a whole other set of problems.”

Complications with breaking down the individual HCPCS codes to meet the NDC standards pushed the launch date to July 1. Failed attempts to develop the software that would link the two coding systems together and prevent fraud and abuse, forced Medicare to table the plans.

“They couldn’t write the software,” Letson said. “Getting the NDC number to match up with the HCPCS code was too complicated.”

Ward Cook, president of Allegro Medical Billing in Tampa, Fla., said while the NDC system is a more exact billing method, such a transition from the HCPCS system would not be worth the effort.

“To change everything over from HCPCS to NDC would be quite a cumbersome task,” he said. “I don’t see any benefit for Medicare, unless they plan on changing the allowables, which is not going to happen.” HME

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