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NDC/HCPCS Crosswalk

The NDC/HCPCS crosswalk file provides a list of National Drug Codes (NDC) that are assigned to a Level II HCPCS along with conversion factors that are used to price the applicable billings to allow processing of claims filed using the NCPDP format.

PDAC updates the file monthly to add, revise or delete NDCs as published by Redbook. The file provides all prior updates, along with details on the changes that occurred in that month.

The PDAC only adds and updates the NDC/HCPCS that are billable to the DMEMACs. Prior to the effective PDAC contract date of August 2008, all NDCs were updated. While these are still listed on the crosswalk file, they are not updated as changes are reported in Redbook.

Listed below are frequent questions received regarding the NDC/HCPCS Crosswalk file. For questions not covered here, please call or email the PDAC Contact Center.

Why is an NDC and/or drug not listed on the crosswalk?
Either it is not a DME billable drug, or it is not listed on the Redbook file the PDAC uses to develop the monthly crosswalk file.

A NDC is listed in Redbook and is billable to the DME MAC. Why is it not on the crosswalk?
NDCs that have not been mapped to a HCPCS by Redbook are filtered out of PDAC’s monthly process. If it is billable to the DME MAC, please contact the PDAC to request the NDC be added to the crosswalk file.

How do I bill a drug whose NDC is end-dated on the crosswalk?
Contact your DME MAC for billing direction.

For NDC/HCPCS crosswalk questions or file layout, click on the NDC/HCPCS Crosswalk Q & A document.