NDC codes

FDA NDC Directory
Product NDC (as listed)65174-270Labeler and product segments. Claims need a package NDC.
Product NDC at billing width65174-0270Add the package segment from the table below.
Package NDCs as listed with the FDA, and the 11-digit 5-4-2 form used on claims. The highlighted digit is the added leading zero.
Package NDC11-digit (billing)PackageCopy
65174-270-306517402703030 INJECTION, POWDER, FOR SOLUTION in 1 KIT (65174-270-30)Marketed from Dec 30, 1987

How the 11-digit form is made: The product segment has 3 digits, so one leading zero is added to it (5-3-2 → 5-4-2). Formatting the NDC does not by itself make it billable — the product, package and quantity must match what was dispensed or administered, and payer rules apply. Conversion rules

Product information

Brand name (proprietary)
Draximage Maa
Generic name (nonproprietary)
kit for the preparation of technetium tc 99m albumin aggregated
Active ingredients
Albumin aggregated — 2.5 mg/1
Dosage form
Injection, Powder, For solution
Route
Intravenous
Product type
Prescription drug
Marketing category
BLA — Biologics License ApplicationApplication BLA 017881
Marketing start
Listing expires
Identifiers
Product ID 65174-270_889b7899-9b87-47c2-bb8b-dc896b305186SPL ID 889b7899-9b87-47c2-bb8b-dc896b305186SPL set ID bbefaa05-1dc0-3ae7-7264-ce1eddf0da2bUNII 799C8VF17R

Billing references

What Med-Code can say about coding this product, and where each statement comes from. Nothing here is inferred from the name alone.

HCPCS codeNo match

No drug-specific HCPCS code in Med-Code's directory for this product. The directory is curated and not complete — check the current CMS HCPCS file before billing.

Administration

Drug administration (CPT 96360–96549)

When a clinician administers the drug, the administration is reported separately. Codes in this range cover hydration, therapeutic injections and infusions, and chemotherapy or other complex drug administration. The right code depends on route, duration and drug type, and self-administered drugs are not billed this way.

How CPT relates to drug billing

NDC on a medical claim

N465174027030 followed by a unit qualifier and the quantity

Package 65174-0270-30. Unit qualifiers: F2 (international unit), GR (gram), ME (milligram), ML (milliliter), UN (unit (each)). The qualifier and quantity depend on what was given. About the N4 qualifier

Product label

Current FDA label (SPL), effective .

Indications (excerpt from the label)

DRAXIMAGE MAA, after radiolabeling with sodium pertechnetate Tc 99m, is indicated for: Lung scintigraphy as an adjunct in the evaluation of pulmonary perfusion in adults and pediatric patients. Peritoneovenous shunt scintigraphy as an aid in the evaluation of its patency in adult patients. DRAXIMAGE MAA, after radiolabeling with sodium pertechnetate Tc 99m, is a radioactive diagnostic agent indicated for: Lung scintigraphy as an adjunct in the evaluation of pulmonary perfusion in adults and pediatric patients. (1) Peritoneovenous shunt scintigraphy as an aid in the evaluation of its patency in adults. (1)

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

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