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Beginning September 1, 2012, in addition to the Healthcare Common Procedure Coding System (HCPCS) code for specialty medications, Cigna will require the National Drug Code (NDC) on some claims.  Cigna will require both the HCPCS code and the NDC when the patient’s plan requires precertification for outpatient services, when the place of service is the physician’s office or the patient’s home, and when Cigna is the primary payer for the following HCPCS:

• J0725 – Injection, chorionic gonadotropin, per 1,000 USP units
• J1830 – Injection, interferon beta – 1b, 0.25 mg
• J2941 – Injection, somatropin, 1 mg

The NDC is not required on claims that are submitted when using Cigna Home Delivery Pharmacy.  More information can be found on the Cigna for Health Care Professionals website.  Once logged in, go to “Resources” and then “Clinical Reimbursement Policies and Payment Policies” and finally “Specialty Claims Requiring NDC”.

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