It is the new version of the National Council for Prescription Drug Programs (NCPDP) code set. It was created to address various business needs of the healthcare industry. HIPAA law mandates that all pharmacies and health care plan should use NCPDP D.0 for all transmissions.

The compliance date for NCPDP D.0 is January 1, 2012.

Yes! If your version number of PrimeRx reads 2.3.x.x or greater; you have a D.0 compliant version of PrimeRx.

Immediately contact our support department for a free upgrade. You must be compliant prior to the January 1, 2012 deadline.

COB (Coordination of Benefits) method relates to what information about the payments and patient responsibility amounts received from the primary insurance is sent to the secondary insurance. Each insurance who acts as a secondary payer has to define which COB method they prefer to receive as part of the secondary billing. Most of the commercial insurances expect method 1 or 2 while most of the state Medicaid and other state related insurances expect method 3.

Create the compound as you normally would. However be sure that NDC-Q is set to 00 and the billing NDC Code MUST have only one 0 at the beginning. In version 2.3.2.0 and above, this is automatically done by the system. Users of earlier version will have to do this manually. It is recommended that users who fill compounding prescriptions should upgrade to version 2.3.2.0 or greater.

Basis of Cost should be entered in the Insurance File for each insurance. If Basis Of Cost is not entered in the compound ingredient grid of the rx, the system will use the Basis of Cost defined in the Insurance being billed. 

These values can be specified by opening the required drug file for editing. Go to the Misc. Info tab. Notice the Route of Admin (SNOWMED) drop down in the “Compound Related Values” area. Select an appropriate value from, this drop down.  

This can be done by going to Maintenance > System File, Pharmacy Information tab. Specify the type of service you provide by selecting a closely matching description from the “Ph Service Type” drop down.

Open the concerned patient’s profile for editing. Go to the “More Patient Info” tab. Notice the “Patient Residence” drop down near the bottom of the window. Select a desired value from here.