Can/should the 278 transaction be used for authorizations for non-formulary drugs?
The transaction does not seem to be designed to perform this function (a cursory view of the IG does not indicate anywhere to record drug prescription as the reason for the request and nowhere to record drug dosage, etc.). I cannot find any guidance in the regulations on this issue.
Has anyone dealt with this issue? If so, can you please share your conclusions?
Thank you,
Ellen Tatge
IS Project Manager
Presbyterian Healthcare Services
505/923-6882
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