RxRenewal

rxrenewal overview an rxrenewalrequest is originated by the pharmacy this message is for the purpose of requesting approval for additional refills of a prescription r 313 rxrenewalrequests shall not be sent back to the prescriber for prescriptions where prohibitrenewalrequest was set to true note if a patient has approved refills remaining on a current prescription, no electronic message is required for a dispensing to occur an rxrenewalresponse is sent by the prescriber to the pharmacy in response to a request to refill a prescription the response indicates whether the rxrenewalrequest has been approved, approvedwithchanges, denied, replaced, or pending an approved, approvedwithchanges, or replace response indicates the current fillable prescription in this case, a cancelrx is not sent for the original prescription following the rxrenewalresponse note the medicationresponse element contains the medication information that the prescriber is approving within an rxrenewalresponse the approved, approvedwithchanges, or replace rxrenewalresponse is considered a fillable message rxrenewal requirements fillable rxrenewalresponse messages for controlled substance medications must be digitally signed the rxrenewalrequest schema supports both a medicationprescribed and a medicationdispensed loop the medicationdispensed element is the required element to be used per the rxrenewalrequest schema in an rxrenewalrequest, one medication loop must contain writtendate if the medicationprescribed loop is not present, then the medicationdispensed loop must provide writtendate when sent, pharmacyrequestedrefills must not be "0" (zero) do not send this element if you want to allow the prescriber to determine appropriate number of refills rxrenewal best practices the medicationdispensed element is used by the pharmacy to designate what the pharmacy is requesting for a renewal the prescribing system reviews the request and sends their response to the medicationdispensed in the medicationresponse element examples newrx sent by prescriber with substitutions allowed medicationprescribed lipitor 10 mg oral tablet numberofrefills 1 pharmacy dispenses atorvastatin 10 mg oral tablet pharmacy sends an rxrenewalrequest with the following information medicationprescribed lipitor 10 mg oral tablet numberofrefills 1 medicationdispensed atorvastatin 10 mg oral tablet pharmacyrequestedrefills 2 prescriber approves (based upon medicationdispensed) and sends an rxrenewalresponse response type approved medicationresponse atorvastatin 10 mg oral tablet numberofrefills 2 response type approvedwithchanges medicationresponse atorvastatin 10 mg oral tablet numberofrefills 6 response type replace medicationresponse lipitor 10 mg oral tablet numberofrefills 2 note for more information on refills and number of dispensings, see the numberofrefills docid\ duaepp1 xr4e6crtd 6sh section if the non epcs authorized prescriber receives an rxrenewalrequest for a controlled substance, they respond with a denied message to the pharmacy should the prescriber wish to approve the request without having the "controlledsubstance" service level enabled, they may then continue with their non electronic data interchange (edi) workflow as determined by their application the ndc/productcode in the rxrenewalrequest should not be the sole determination of the identification of the requested medication when the incoming ndc does not match the related newrx or cannot be found, systems should use other potential identifiers (e g , rxnorm codes) and should always allow manual review of the drug description by the user therefore, all response types should be permitted (i e , approved, approved with changes, denied, and replace) note for more information on how to send a followuprequest, see the followup request element usage docid\ hovvjdqkj xmo5y9ld nt section rxrenewal prescriber best practices prescribers should review all requests prescribers should not delete a request message from a processing queue without a response being generated to the requester prescribers should respond to rxrenewalrequests within 48 hours see rxrenewal ltpac best practices docid 2dafk lmsgzoaw8rfhla6 section for exception information when using the pending response, the provider should populate the reason code and expectedpendedresponsedate so the pharmacy knows when to expect an approval or denial to the request if a message is received with a requestexpirationdate, the receiving system should not send a response after that date matching a request back to an original message is not required to present the rxrenewalrequest to the prescriber see the message linkage docid\ z6fpm0mwoma78wtdrn5dk section for more details if another prescriber is responding to an rxrenewalrequest for non controlled substances on the original prescriber's behalf (i e , original prescriber who is out of the office), then one of the following options should be used for controlled substance requests see rxrenewal epcs requirements docid 2dafk lmsgzoaw8rfhla6 prescriberagent used if the prescriber is out for a short time the prescriber field in the rxrenewalresponse should contain the prescriber's name the prescriberagent element should contain the name of the agent that is authorized to respond to refills for the prescriber the rxrenewalrequest should be responded to with the rxrenewalresponse type of replace alternate prescriber when the original prescriber is unable to respond, the rxrenewalrequest should be responded to with the rxrenewalresponse type of replace the new prescriber information should be populated in the prescriber elements the new prescriber’s spi should be sent in the from element of the message header if the original prescriber is the prescriber who should be handling any subsequent requests, the original prescriber information can be sent in the followupprescriber elements rxrenewal pharmacy best practices if the prescriber has not responded within 48 hours the followuprequest workflow should be utilized see rxrenewal ltpac best practices docid 2dafk lmsgzoaw8rfhla6 for exception information when a pending response is received, a pharmacy should not send follow up requests until the day after the expectedpendedresponsedate if request is no longer necessary, then a subsequent message with the retraction/withdrawal indicator included in the header should be used for more information, see the messageindicatorflag element in the message header elements docid\ czdkqc3 xhkcw1b ejddx section if a response will not be accepted by a pharmacy after a specific time limit, then that date should be populated in the requestexpirationdate a pharmacy may send an rxrenewalrequest for controlled substances regardless of whether the prescriber has the "controlledsubstance" service level for rxrenewal routing if followupprescriber was populated and prohibitrenewalrequest was set to "true", the corresponding rxrenewalrequest should be sent to the followupprescriber’s spi otherwise, retain the original sending spi for the electronically received newrx evaluate this spi (e g , has refill service level), and send rxrenewalrequest to this record if the original sending spi is not available or does not have refill service level, then it is important to ensure that when sending an rxrenewalrequest the correct spi is selected based on service level and location for example, confirm the individual npi, address line 1 or address line 2, postal code, phone fax, or clinic name prior to sending the message rxrenewal epcs requirements denied and replace responses must be the only allowed rxrenewalresponse types for all controlled substances the prescriber signing the rxrenewalresponse to approve a controlled substance populates the prescriber element with their information, even if they are responding to a request that was sent to another prescriber rxrenewal ltpac best practices rxrenewalrequests may be generated as an option for open orders that have hit their regulatory expiratory limit prescribers in the ltpac industry might not respond to rxrenewalrequests in a care setting for up to 30 days pharmacies will want to understand that this length of time may impact workflows for follow up requests or urgent needs