Frequently Asked Questions

Med-Code is a searchable reference for medical drug and billing codes, including National Drug Codes (NDC), HCPCS codes, J-Codes, and selected CPT codes. Use Med-Code to quickly look up codes, understand their descriptions, and explore relationships between drug and billing identifiers.

Med-Code is useful for medical coders, billers, healthcare professionals, revenue-cycle teams, researchers, and anyone who needs to identify or understand a drug or medical billing code.

Med-Code is a reference resource and should not replace official coding guidance, payer policies, or applicable regulatory requirements. When a coding or billing decision affects a claim, reimbursement, or compliance requirement, verify the information against the appropriate authoritative source.

NDC stands for National Drug Code. It is used to identify specific drug products in the United States. An NDC identifies three key pieces of information: the labeler (the company responsible for the drug), the product (the specific drug, strength, and dosage form), and the package (the package size and type). This three-part structure allows a specific drug product and package configuration to be identified.

An NDC-10 is the FDA’s 10-digit format, while NDC-11 is a standardized 11-digit format commonly used for healthcare billing. NDC-11 uses a 5-4-2 segment structure. The conversion from NDC-10 to NDC-11 is performed by adding a leading zero to the appropriate segment. For example, if an NDC-10 is formatted as 12345-6789-0, it becomes 12345-6789-00. The zero is added to the package segment because that segment contains only one digit in the original format. For more examples and the complete conversion rules, see the NDC-10 to NDC-11 conversion guide.

Healthcare billing systems commonly require NDC information in a standardized 11-digit format. Using the wrong segment padding can produce an incorrect NDC-11 value even when the original NDC-10 is valid. Always verify the original NDC before converting it.

Enter the NDC into the NDC lookup tool. You can use an NDC to identify information associated with the labeler, product, package, drug, strength, or dosage form, depending on the available data.

HCPCS stands for Healthcare Common Procedure Coding System. HCPCS contains two levels: Level I consists of CPT codes, and Level II consists primarily of alphanumeric codes used for products, supplies, drugs, services, and other items not represented by CPT codes. J-Codes are part of HCPCS Level II.

A J-Code is a HCPCS Level II code beginning with the letter J, followed by four digits. J-Codes are primarily used to report certain drugs and biological products. For example, J9271 is the code for injection, pembrolizumab, 1 mg. The code descriptor specifies the billing unit used for reporting the drug.

Use the J-Code lookup and search by the J-Code or drug name. For example, searching for Keytruda can identify its associated J-Code, while searching for J9271 can identify the drug and code descriptor.

The billing unit tells you how much of the drug is represented by one unit of the HCPCS code. For example, if a J-Code represents 1 mg and the documented dose is 440 mg, 440 mg divided by 1 mg equals 440 billing units. Each J-Code page includes an interactive unit calculator that works this out automatically from the entered dose.

A J-Code identifies the drug that was given. A CPT administration code reports how it was given, such as the injection or infusion procedure performed. A claim for a clinician-administered drug often needs both codes together.

CPT stands for Current Procedural Terminology. CPT codes are maintained by the American Medical Association and are primarily used to describe medical procedures and services.

Vaccines are typically billed using CPT codes for the vaccine product and its administration rather than a J-Code. See the vaccine and immunization codes covered in this directory.

A drug can have multiple identifiers because different coding systems serve different purposes. For example, the same medication may have an NDC identifying a specific manufacturer, product, strength, and package; a HCPCS/J-Code used for healthcare billing; and a CPT code associated with a procedure or administration service. The exact identifier needed depends on the purpose of the lookup or billing transaction.

A drug name alone may not uniquely identify a product. Different manufacturers, strengths, dosage forms, package sizes, and formulations can have different NDCs or billing relationships. For an accurate lookup, additional information such as the NDC, strength, dosage form, or product description may be required.

A billable code is a code that can be reported for a qualifying service or product when the applicable coding, documentation, coverage, and payer requirements are satisfied. A code being listed as billable does not by itself guarantee payment or reimbursement.

NDC identifies a specific drug product and package. HCPCS Level II identifies products, supplies, drugs, biologicals, and other reportable items, including the codes used for injectable and infused drugs. CPT describes medical procedures and services, including how a drug was administered. The Coding Guide walks through how these systems fit together on an actual claim.

Choose the relevant lookup or directory and enter the identifier or drug information you have. Depending on the tool, you may be able to search by code, drug name, brand name, or other identifying information.

Try searching with another identifier or a shorter version of the drug name. For example, if a full drug name does not return a result, try the brand name, generic name, NDC, or HCPCS code. If the code still cannot be found, verify the information against the relevant official coding source.

If you find information that appears incorrect or outdated, contact the Med-Code team with the code or drug information and a description of the issue. Providing the source or evidence supporting the correction can help with review.