All situational elements must indicate how this information is an essential component to the adjudication of the claim especially when other information is provided at the service line. Because the guide fails to provide the business rules for additional specificity, we urge that the implementation guide remove the reference to the NDC from the institutional guide . The only situation that warrants the reporting of the NDC is when the provider dispenses drugs for take home. Currently institutional providers do not report at the line-item level the physician or other caregiver information . Moreover, virtually none of those who subscribe to this added system feature has the ability to interface this information with their billing record without costly redesign.
Recommendation Remove the reference to physician information at service line.
This item calls for the inclusion of the physician specialty on every institutional claim and would also be linked to the prior item 128. Institutional claims should not need to have on each claim a physician specialty those assignments should be kept in the National Provider Identification file and health plan files.