NDC Analysis Reports
Analysis Summary
This report provides summary counts for three summaries, based on the first analysis selected on the Filters pane and summary counts for exceptions found in the analysis process of the CDM file. The summary counts do not include inactive and excluded items. Click the count hyperlink to review the report details.
Export file name:
- Summary
All CDM Line Items
This report contains all imported line items that haven’t had an analysis performed on them. Once an analysis is complete, the counts may be different because the items may not meet the report criteria for All CDM Line Items.
Export file name:
- All CDM Items
All Excluded CDM Line Items
This report contains all excluded line items that do not appear in any analysis reports. If you need an export, you must run the analysis separately and export the file afterward.
Export file name:
- All Excluded Items
Bill Unit Variance
This report allows you to compare the bill units from analysis of your NDC/HCPCS during NDC analysis to the bill units in your CDM file.
This report identifies if bill units in your CDM file do not match the NDC and CPT/HCPCS combination. This report also identifies if bill units are missing from your CDM file but are applicable according to the NDC and CPT/HCPCS combination.
Cost to Charge Analysis
This report calculates the variance amount and percent of variance between the cost and charge/price fields.
NDC No Longer Manufactured
This report includes all NDC codes that are no longer being manufactured.
Export file name:
- NDC No Longer Manufactured
Description Review
This report displays a list of line items and their descriptions that have a valid NDC code. This report also includes the NDC description and the CPT/HCPCS code and description.
Click the CPT/HCPCS or the NDC code on the Results table to open the Code Detail pane.
This report can be used to compare the CPT/HCPCS and NDC descriptions to the file description for inconsistencies.
This report displays the following columns on the Results table and Code Detail pane:
- Labeler Name
- ASP Price
- Pkg Size
- Bill Units, Bill Pkg
- SD/MD per each
- SD/MD per pkg
- Route of Administration (ROA) is available to display within the table.
Export file name:
- Description Review
Invalid NDC Code
This report displays a list of lines items that are not included in Vitalware's VitalKnowledge database.
Review NDC format to ensure labeler and other drug specific details are accurate and include leading zeroes, if required.
Export file name:
- Invalid NDC
NDC APC Payment
This report displays a list of line items that have valid NDC and CPT/HCPCS code combinations. Additional NDC specific columns are available for display when this report is selected.
In the NDC tab on the Code Detail pane, the ASP Allowable amounts are calculated using the ASP pricing plus 6% times the billable units for the specific NDC and CPT/HCPCS code combination. The variance and the variance percentage are then calculated using the charge amount listed in the file and the APC payment amount.
In the NDC tab on the Code Detail pane, the AWP Price Limit the payment limit amount based on CMS AWP pricing files and may be the same as the APC payment amount depending on the Status Indicator assigned to the CPT/HCPCS code.
CPT/HCPCS codes with a Status Indicator “N” are not included on this report. Click the CPT/HCPCS code to open the APC Info tab on the Code Detail pane.
Export file name:
- NDC APC Payment Exception
NDC Pricing Analysis
This report displays a list of line items in the file that have a valid NDC and CPT/HCPCS code combination in Vitalware’s best practice suggestions.
This report displays the following columns on the Results table and Code Detail pane:
- Average Sales Price (ASP)
- Average Wholesale Price (AWP)
- Status Indicator
- Additional NDC specific columns listed under Description Review
An export is not available for this report.
NDC to CPT/HCPCS Mismatch
This report displays a list of line items that have a missing or improper CPT/HCPCS code as related to the NDC code in the CDM file.
Click the CDM charge code, CPT/HCPCS (if present) code, or NDC code on the Results table to display the Suggested Codes and NDC tabs on the Code Detail pane. These tabs display CPT/HCPCS codes that are associated with the NDC.
An export is not available for this report.
Suggested Rev Code Assignment
This report displays a list of line items that are missing a CPT/HCPCS code associated with the NDC and/or have a CPT/HCPCS combination that does not match Vitalware's best practice suggestions for revenue code assignment.
The Suggested Codes tab on the Code Detail pane list the revenues codes and CPT/HCPCS that are associated with the NDC.
The Suggested Rev Codes tab downloads as an additional document when this report is exported.
Export file names:
- Revenue Codes Assigned
- Suggested Revenue Codes