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Thanks
for the initial input on the 278, and now there is a follow up question that we
would appreciate comment on. Thanks!
Based
on feedback from the WEDI list serv,
the 278 is to be used by providers for prior authorization for any
drug authorization, but the detail
question is how? According to the IG
the UM segment identifies the type of health care service review. The data
element UM03 is service type code. The service type code has nearly every
authorization request possible, Hospice, DME, Surgical, Dental, Inpatient stay,
etc.. But it does not have medication,drug or pharmacy. Is there a service type
code for drug authorization that we are missing? Are we looking in the right
spot? Is the only choice to use the MSG segment to free format the
request? What are other sites doing to identify that the 278 request is a
drug authorization?
Deborah,
That would be my take.
The opinions expressed here are my own and not necessarily the opinion of
LCMH.
Douglas M. Webb Computer System Engineer Little Company of Mary
Hospital & Health Care Centers [EMAIL PROTECTED]
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----- Original Message -----
Sent: Thursday, May 29, 2003 01:09
PM
Subject: RE: 278 Question
It
is my understanding that the NCPDP is intended to be used only in the retail
pharumacy situation. The proper transaction for a prescriber who seeks
PA for a particular drug is the 278. We are acting accordingly.
Does anyone have a different impression?
Deborah Drexler, JD
Director of Privacy Compliance
Commonwealth Medicine
University of Massachusetts Medical School
Benedict Building, 55 Lake Avenue, Worcester
01655
ph 508-334-7096 fx
508-856-1212
[EMAIL PROTECTED]
The Minnesota HIPAA Collaborative subgroup for Data Issues is
currently working through the 278 guide to collectively review and
document a companion guide. A question came up that we would like to
pose to this listserv.
Is the 278 intended to be used for prior
authorizations for pharmacy (i.e. medications)? Not commercial
pharmacies but by providers or care systems? If so, are organizations planning to use
the 278 for this? ---
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