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​​Enhanced Claim Editor Program: Obsolete NDC codes​

May 4, 2023

​The AmeriHealth HMO, Inc. and AmeriHealth Insurance Company of New Jersey (AmeriHealth) Enhanced Claim Editor Program will include automated edits for obsolete National Drug Codes (NDCs).

An NDC is deemed obsolete 30 months after its inactive date. Any claim received with an obsolete NDC code will be denied as incorrectly coded.

The AmeriHealth Enhanced Claim Editing Program supports our commitment to ensure compliance with reporting requirements and guidelines endorsed by national and regional industry sources.

We continue to evaluate and review our claim payment policies, industry standard sources, and specialty societies to identify additional claim edits and make changes where necessary.

Resources

For questions about the enhanced claim editing process, review our Enhanced Claim Editor Program: Frequently asked questions (FAQ). If you still have questions after reviewing these resources, please send an email to ahclaimeditquestions@amerihealth.com.​


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