Actually the addenda (final, final rule) names the NCPDP  5.1 and 1.1 as the
referral, certification and authorization transaction for retail pharmacy
---- not the 278. 

Barb Hollerung
MN Medicaid
Ph.  651-297-7222
Fax 651-297-3230
[EMAIL PROTECTED]

 -----Original Message-----
From:   Robert C. Pozniak [mailto:[EMAIL PROTECTED] 
Sent:   Thursday, April 03, 2003 4:16 PM
To:     WEDI SNIP Transactions Workgroup List
Cc:     WEDI SNIP Transactions Workgroup List
Subject:        Re: Transactions question


The X12 standards 276 and 278 are the only ones named for those
transactions in the final rule.  See 162.1301 &162.1302 for referral
certification and authorization.  Claim status inquiry/response is covered
by 162.1401 & 162.1402.

Unlike eligibility or claims that allow for the NCPDP standard or X12 to be
used  only the X12 standards are allowed for the transactions your asking
about.

Robert C. Pozniak
NYS Department of Health
HIPAA Practice Group



 

                      "Jonathan Fox"

                      <[EMAIL PROTECTED]        To:       "WEDI SNIP
Transactions Workgroup List"           
                      health.com>
<[EMAIL PROTECTED]>                         
                                               cc:

                      04/03/2003 03:49         Subject:  Transactions
question                             
                      PM

                      Please respond to

                      "Jonathan Fox"

 

 






Two seemingly simple questions that are troubling.

Do the 276 and 278 apply to pharmacy claim information and requests for
pharmaceutical authorizations respectively?

Your thoughts and/or supporting textual references are appreciated.

Thanks.

Jonathan Fox
Independent Health

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The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions 
on this listserv therefore represent the views of the individual participants, and do 
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you wish to receive an official opinion, post your question to the WEDI SNIP Issues 
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