Remark code M119 indicates that the claim has been flagged due to a missing, incomplete, invalid, deactivated, or withdrawn National Drug Code (NDC). This means that the information provided for the NDC, which is a unique identifier for medications, is either not present, not fully provided, contains errors, or references a code that is no longer active or has been removed from use. To resolve this issue, the healthcare provider must review the claim, correct the NDC information, and resubmit the claim for processing.
Ways to mitigate code M119 include implementing a robust pharmacy inventory management system that ensures all National Drug Codes (NDCs) are current and active. Regularly update the NDC database to reflect any changes in drug formulations or packaging. Train staff to accurately record NDCs during the billing process and conduct periodic audits to check for accuracy and completeness. Utilize electronic health record (EHR) systems with integrated decision support tools that alert staff to missing or invalid NDCs before claims submission. Establish a protocol for double-checking NDCs against the FDA's published list, especially when dealing with newly approved or recently changed medications.
The steps to address code M119 involve several key actions to correct the issue with the National Drug Code (NDC). First, verify the accuracy of the NDC on the original claim submission. Ensure that the NDC is current, active, and corresponds to the drug or product administered. If the NDC was incorrect or incomplete, update the claim with the correct NDC information.
Next, check that the NDC is formatted correctly, following the 11-digit, 5-4-2 format (including leading zeros if necessary). If the NDC was deactivated or withdrawn, identify the appropriate, active NDC for the drug provided and revise the claim accordingly.
Once the correct NDC is identified and verified, resubmit the claim with the updated NDC information. Keep a record of the changes made and monitor the claim to ensure that it processes successfully upon resubmission. If the issue persists, consider reaching out to the payer for further clarification on the specific requirements for NDC reporting on claims for their policies.