Difference Between HCPCS and NDC (With Table)

The American health care 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. 

HCPCS vs NDC

The difference Between HCPCS and NDC is the systems they are managed by and their use. The healthcare common procedure coding system is handled by the CMS agency. Its full form is Centers for Medicares and Medicaid Services agency. It is used by physicians, hospital professionals, and providers. Whereas 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 Between HCPCS and NDC

Parameters of ComparisonHCPCSNDC
Full FormsThe full form of HCPCS is the Healthcare Common Procedure Coding System.The full form of NDC is the National Drug Code.
MeaningHCPCS is the set of procedure codes of health care.NDC is the product identifier that is used for the drugs intended for individual use.
EstablishmentsThe establishment of HCPCS is done in 1978.The establishment of NDC is done in 1972.
MandatoryIt is mandatory since the year 1996.It is mandatory since its emergence.
Managed ByThese 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.
CodesIt is a 5 character code.It is a 10 character code.
Code SegmentationThe code of HCPCS is not segmented.NDC is segmented into three parts such as Labeler, Product, and Package Codes.
Use of codesHCPCS 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.

It is the medical billing process, that is necessary to describe the products and services during medical transactions. These codes are recognized, proclaimed, and operated by the Centers for Medicares and Medicaid Services (CMS) agency. CMS is a federal entity, which is responsible for the health care policies. It was the old HCFA before HCPCS became.

The codes were deliberate before the formation of the Health Insurance Portability and Accountability Act in the year 1996. Since then, it became obligatory. HCPCS is further divided into three levels, Level I, Level II, and Level III HCPCS. The code is of 5 characters, 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 is mandatory since the emergence.

NDC codes are made for widespread individual people. It is situated on the outer packaging of drugs. These codes are recognized, proclaimed, and regulated by the Food and Drug Administration (FDA) agency. It regulates the certainty and progression of 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 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 become mandatory since the year 1996. Conversely, the second was compulsory since the emergence.
  5. The previous codes are recognized, listed, and regulated by the Centers for Medicares 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 for hospital providers, physicians, and health professionals. Whereas NDC is used for the general individual user.

Conclusion 

The former coding system is specially made for hospital procedures and professionals. It is a series of medicare diagnosis codes. The latter is established to control the consumption of drugs into the medicines as it applies to every individual. It helps to identify the unique medications.

They both are used for billing and are applicable in distinct medical conditions. The HCPCS is implemented in hospitals, on the professionals, and medical service providers. Whereas the national drug codes are executed via the packaging of every drug. Because it works for the safety of each user individually.

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

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