DFEC List of National Drug Codes (NDCs) That Will Deny

Division of Federal Employees' Compensation (DFEC)

On February 14, 2018, DFEC published FECA CIRCULAR 18-05, Medication "Convenience" Kits and Combination Medications. On February 22, 2019, DFEC published FECA Circular 19-05 (FDA Medical Devices).

In accordance with the discretion granted to DOL and delegated to OWCP, DFEC has instituted a new policy pertaining to payment of specific NDCs (for both medications and FDA Medical Devices). Payment will deny if DFEC has determined that the items in the kit, medication or FDA medical device can typically be obtained separately and/or at a lower cost, there is a reasonable alternative or substitute; or the primary use is for a condition not normally not caused by a workers' compensation injury. A strict exception based policy is described in the Circulars.

DFEC's list of denied NDCs can be found below, with the effective date of the denial. DFEC will continuously and regularly review and evaluate NDCs in accordance with the above policy and set the corresponding NDC to deny. As new NDCs are added, this list will be updated. Providers are expected to review this list prior to dispensing to determine if the NDC will be covered for payment.