Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: March 21, 2019

Program Area: Distributed Data Collection (DDC) for RA Including HCRP/EDGE Server

Question: The NDC on my pharmacy claim is valid, but the fill date is outside the effective date of the NDC. Can I submit this claim with a qualifier of 01?

Answer: Pharmacy claims with fill dates outside the effective range of the NDC are not considered valid pharmacy claims. These claims must not be submitted to EDGE.

HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.