HCPCS vs NDC: Difference and Comparison

The American healthcare system is an innovative driver that creates and widely supports advanced and life-enhancing therapies and includes a wide array of solutions for Medicare buyers. The present healthcare systems offer tremendous beneficiaries.

But there are substantial opportunities for the reformation that would minimize expenses, extend services, improvise transparency, and empower healthcare and wellbeing.

That is when services, acts, and systems like HCPCS and NDC intervene in the circumstances. HCPCS is the Healthcare Common Procedure Coding System. And the NDC is National Drug Code. 

Key Takeaways

1. HCPCS codes are used to identify medical services and procedures, while NDC codes are used to identify specific drugs and medications.
2. HCPCS codes are used for billing and reimbursement, while NDC codes are used for drug tracking and monitoring.
3. HCPCS codes are updated annually, while NDC codes are updated every six months.

HCPCS vs NDC

The difference Between HCPCS and NDC is the systems they are managed by and their use. The CMS agency handles the common healthcare procedure coding system. Its full form is the Centers for Medicare and Medicaid Services agency. It is used by physicians, hospital professionals, and providers. In contrast, the national drug code is applied to every single individual. It is specially made for general people by the Food and Drug Administration (FDA) agency. 

Comparison Table

Parameters of Comparison	HCPCS	NDC
Full Forms	The full form of HCPCS is the Healthcare Common Procedure Coding System.	The full form of NDC is the National Drug Code.
Meaning	HCPCS is the set of procedure codes of health care.	NDC is the product identifier that is used for the drugs intended for individual use.
Establishments	The establishment of HCPCS is done in 1978.	The establishment of NDC is done in 1972.
Mandatory	It is mandatory since the year 1996.	It is mandatory since its emergence.
Managed By	These codes are identified, reported, and managed by the Centers for Medicares and Medicaid Services (CMS) agency.	These codes are identified, reported, and managed by the Food and Drug Administration (FDA) agency.
Codes	It is a 5 character code.	It is a 10 character code.
Code Segmentation	The code of HCPCS is not segmented.	NDC is segmented into three parts such as Labeler, Product, and Package Codes.
Use of codes	HCPCS codes are used for hospital providers, physicians, and health professionals.	NDC codes are used for common individual people.

What is HCPCS?

The full form of HCPCS is the Healthcare Common Procedure Coding System. It is also known as the Health Care Finance Administration (HCFA). The codes are based on the Current Procedural Terminology of the American Medical Association.

HCPCS is the set of procedure codes of health care that was established in 1978. The usage of HCPCS codes for hospital providers, physicians, and health professionals.

The medical billing process is necessary to describe the products and services during medical transactions. The Centers for Medicare and Medicaid Services (CMS) agency recognises, proclaims, and operates these codes.

CMS is a federal entity which is responsible for health care policies. It was the old HCFA before HCPCS became.

The codes were deliberate before the Health Insurance Portability and Accountability Act was formed in 1996. Since then, it has become obligatory.

HCPCS is divided into three levels: Level I, II, and III HCPCS. The code is of 5 characters, and the characters are not segmented.

What is NDC? 

The full form of NDC is the National Drug Code. NDC is the product identifier that is uniquely used in the U.S. for the drugs intended for individual use. It was established in 1972. These listings require registered drug establishments, so it has been mandatory since its emergence.

NDC codes are made for widespread individual people. It is situated on the outer packaging of drugs. The Food and Drug Administration (FDA) agency recognises, proclaims, and regulates these codes.

It regulates the certainty and progression of the population Medicare. 

It is a 10-character code. NDC is segmented into three parts such as Labeler, Product, and Package Codes. In this way, the data of drugs are classified, analyzed, and kept in databases like GPI (Generic Product Identifier). 

Main Differences Between HCPCS and NDC

1. A set of procedure codes of health care is HCPCS, whereas the product identifier of the unique drugs is intended for individual users in the U.S.
2. HCPCS is the Healthcare Common Procedure Coding System. And NDC is the National Drug Code.
3. The former was established in 1978, while the latter in 1972.
4. The first became mandatory since the year 1996. Conversely, the second was compulsory since its emergence.
5. The previous codes are recognized, listed, and regulated by the Centers for Medicare and Medicaid Services (CMS) agency. On the other hand, the succeeding is by the Food and Drug Administration (FDA) agency.
6. HCPCS codes are of 5 characters. Contrarily, NDC is of 10 characters.
7. The preceding is not segmented. On the converse, the subsequent is segmented into three parts.
8. HCPCS codes are used by hospital providers, physicians, and health professionals. Whereas NDC is used for the general individual user.

References

1. https://academic.oup.com/jncimono/article-abstract/2020/55/46/5837301 
2. https://onlinelibrary.wiley.com/doi/abs/10.1002/pds.4934 
3. https://link.springer.com/article/10.1007/s00198-006-0179-x 

This Article has been written by: Supriya Kandekar

Last Updated : 14 October, 2023