Education & TrainingCommercialBadgerCare Plus and Medicaid SSI ProgramsJune 17, 2025

National Drug Code required for professional and facility outpatient claims

In previous editions of Provider News, Anthem notified providers about a new billing requirement to help us determine the correct amount to pay on drug claim lines for commercial professional and facility outpatient claims filed to us.

Codes required include:

  1. Applicable HCPCS code or CPT® code
  2. Number of HCPCS code or CPT code units
  3. Valid 11‑digit National Drug Code(s) (NDC), including the N4 qualifier
  4. Unit of Measurement qualifier (F2, GR, ML, UN, MG)
  5. NDC units dispensed (must be greater than 0)

If you have questions, please contact Provider Services via the number on the back of our member ID card.

Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield of Wisconsin (BCBSWI), Compcare Health Services Insurance Corporation (Compcare), and Wisconsin Collaborative Insurance Company (WCIC). BCBSWI underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensee(s) of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

WIBCBS-CDCM-082951-25

PUBLICATIONS: July 2025 Provider Newsletter