Hearing Aid NAPPI Codes

Date 29 June 2018

Dear Healthcare Provider,

From 1 January 2017, all hearing aid claims will require the submission of a valid NAPPI code. From 1 April 2017 any hearing aid claim submitted without a valid NAPPI code, will be rejected and a unique rejection code will alert you and your patient of the NAPPI code requirement to rectify this in order to process and pay your claim.

Nappi Codes

Based on the definition in the Medicines and Related Substances Control Act (No 101 of 1965), hearing aids fall within the category termed “medical devices”. In the medical aid industry, the current standard process is that medical devices are identified via unique NAPPI codes. The submission of a NAPPI code with any medical device is an acceptable and standard claims submission norm. It allows for transparent product identification and pricing. The NAPPI code thus enables the processing of claims on a uniform basis, subject to scheme specific benefits and rules.

Claims submission

We have been advised that when you submit your claim for tariff code 821830 or 83051 (global charge for supply and fitting of hearing aid and follow-up), ensure that the NAPPI code is submitted in the descriptor field of the claim. The actual price of the NAPPI code is not required on the claim. The claimed amount for these two tariff codes should be the composite of the cost of the hearing aid and the cost of the associated professional fees.

Medprax Nappi File

We have included all valid NAPPI codes for hearing aids in our Material file. These include the correct pricing for each hearing aid and device, and will be automatically imported into your software when you run your weekly update. You are able to charge the correct price according to the medical aid reimbursement rate. Your software can assist you should you wish to only claim the amount for the tariff codes and submit the NAPPI code at a zero price.

Contact us

Please do not hesitate to contact us should you wish to subscribe to the weekly Material file update.

If you have any questions or need assistance in understanding the requirements for the above hearing aid claims.

Karen Colby

031 9049208

karen@medprax.co.za