Medication Elements

medication elements the following should be used for developing medicationprescribed, medicationdispensed, medicationrequested, and medicationresponse elements element name codes comments drugdescription mandatory drug name (when applicable, include the full drug name, strength, and form) for a compound, the names of the ingredients in the compound or the prescriber’s preferred name should be communicated here see drugdescription best practices docid\ mt2ywyzcdadoeg52zi45y section for more information r 305 the drug name shall be an item that is currently available for dispensing if there are active ndcs available, an inactive/obsolete ndc shall not be used customers are expected to work with their drug compendia vendor to satisfy this requirement r 306 if the drug description for single medications as well as compounds exceeds the length of the drugdescription field, the prescription shall not be sent electronically r 307 when entering a prescription that has a free text drugdescription and the prescription contains a controlled substance, epcs requirements shall be followed for quality check information on drugdescription, see drugdescription best practices docid\ mt2ywyzcdadoeg52zi45y product mandatory within the product element, one instance of drugcoded, compoundinformation, or nondrugcoded must be sent up to 5 repetitions of productcode and drugdbcode can be included within drugcoded, or nondrugcoded drugcoded is used exclusively for medications and including an ndc is required nondrugcoded is used for non medication products that may have an ndc, supplies, durable medical equipment and digital therapeutics if the product has an ndc then it should be included compoundinformation is used to send a compound prescription all active ingredients must be included and inactive ingredients may be included s 208 codified values within a message shall not conflict with the related textual concept ndc conditional mandatory when sending drugcoded, optional when sending nondrugcoded if a product has an ndc it is recommended to include it business rule the ndc must be a valid 11 digit code see ndc best practices docid 8mbt8b1vha5lun2i7jnml for more information strength/ strengthform conditional code mandatory business rule must be a valid fmt/nci code see codified field usage for federal medication terminologies (fmt) codes docid\ xmsfuyh9o04gxlqfxbavk for details strength/ strengthunitofmeasure conditional code mandatory business rule must be a valid fmt/nci code see codified field usage for federal medication terminologies (fmt) codes docid\ xmsfuyh9o04gxlqfxbavk for details deaschedule conditional business rule must be a valid fmt/nci code see codified field usage for federal medication terminologies (fmt) codes docid\ xmsfuyh9o04gxlqfxbavk for details for fillable messages, if the medication is categorized as a controlled substance by the drug enforcement agency (dea) or the state, this field must be sent r 308 when sending a compound with one or more controlled substance ingredients, the message shall contain one of the following either the compoundingredient/deaschedule for each controlled substance in the compoundingredient element or the dea schedule of the most restrictive ingredient in the drugcoded/deaschedule or nondrugcoded/deaschedule element quantity mandatory value mandatory business rule if the drug quantity value uses a decimal, there must be at least one digit to the left and the right of the decimal point; the numbers to the right of the decimals cannot be all zeros, and, if there is more than one digit to the left of the decimal point, they cannot be all zeros for newrx, a quantity value of "0" (zero) indicates an open order used in ltpac systems codelistqualifier mandatory business rule for newrx if quantity/value is greater than "0" (zero), then quantity/codelistqualifier must be "38" for newrx in ltpac if quantity/value = "0" (zero), then quantity/codelistqualifier must be "qs" or "cf" (for compound) and must have long term care service level enabled for compounds the medicationprescribed/quantity/codelistqualifier must be "cf" (compound final quantity) this also applies to the medicationdispensed, medicationrequested, and medicationresponse structures the value "38" is applicable in the quantity element of the compoundinformation structure quantity/value = "0" only applies to ltpac quanityunitofmeasure/ code mandatory business rule must be a valid fmt/nci code see codified field usage for federal medication terminologies (fmt) codes docid\ xmsfuyh9o04gxlqfxbavk for details dayssupply conditional business rule this element is optional when sent, dayssupply element must be a whole number and not contain a decimal point when using the structured sig elements, duration of therapy can be conveyed in the timingandduration elements writtendate conditional business rule the writtendate must not be a future date and should be sent in datetime to accommodate for any time zone conversion issues that may occur this element usage is dependent on message type see schema for element requirements druguseevaluation conditional druguseevaluation details can be included for a number of interactions including drug to allergy, drug to condition, drug to drug and duplicate drugs in addition to including the servicereasoncode, it is recommended to include additional details such as the professionalservicecode and clinicalsignificancecode acknowledgementreason conditional business rule a druguseevaluation acknowledgement reason must be sent when the professional service is equal to "zz" substitutions mandatory it is important that proper product/service substitution codes be used on e prescriptions prescriber application vendors should ensure that their applications guide users to insert the proper codes that accurately express their wishes with respect to substitution numberofrefills conditional quantity for the number of refills when sending an open order, the numberofrefills quantity should be set to 99 sig conditional this element usage is dependent on message type sig contains either completely free text with no corresponding structured content or is a generated structured sig that contains all the elements semantically captured by and corresponding to the codified elements and clarifying free text fields business rule the sigtext value for newrx transactions must meet a fundamental level of safety and quality defined by surescripts examples of unsafe and poor quality sigtext values include sigtext contains only one character or contains only special characters examples "1", " ", " " sigtext is missing multiple key elements, such as dose, route, or frequency examples "oral", "once", "im", "n/a", "po" sigtext contains conflicting directions example "take 1 capsule by mouth twice a day once daily " sigtext mandatory if you cannot fully represent the content of the prescriber’s intended directions in the structured sig only populate the free text see sigtext field best practices docid 3kflinduon0nwub0cit75 section patient instructions should not be split between the sigtext and notes fields as this can result in an incorrect interpretation by the pharmacy staff of the prescriber’s preferred patient instructions which may result in negative therapeutic outcomes and/or patient harm sigs should not be truncated because important information can be lost (structuredsig elements) conditional structured elements supporting the sigtext codified information, the codes and their textual representations are required to semantically match with the string in the sigtext reference ncpdp script structured and codified sig format implementation guide ordercapturemethod conditional identifies how the order is captured; entered by a prescriber, a telephone order (where prescriberagent info should be sent), a verbal order (where prescriberagent information should be sent) or written (when no prescriberagent information should be sent) patientcodifiednote conditional patientcodified notequalifier conditional codified note specific to patient or medication being prescribed patientcodified notevalue conditional when the patientcodifiednotequalifier of aa or ab is sent value can also be sent to provide quantification of the qualifier othermedicationdate conditional othermedication datequalifier conditional qualification of date/time field example qualifiers solddate is only allowed to be used in rxfill notification, and rxrenewalrequest messages effectivedate (begin) used for earliest fill date the date or date/time (now or in the future) after which this prescription being transmitted can be dispensed (i e , do not fill before date) as authorized by the prescriber exception electronic prescriptions for patients receiving ltpac pharmacy services are exempt from the effectivedate usage stated above