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NCPDP Medication Unit Changes and Crosswalk

Overview

Periodically, the certification body for e-prescribing changes standards for transmitting medication information to and from pharmacies. Effective 10/1/19, the National Council for Prescription Drug Programs (NCPDP) made changes to the units permitted for communicating information regarding medication dispensing units. Changes include eliminating English measurement terms (such as ounce) and broad terms (such as bottle). In addition, some units of measurement were deemed unnecessary when the medication name includes an inherent specific dispensing unit (such as twin-pack for EpiPen 2 pack). 

The NCPDP description changes include unit mappings which are acceptable and are included below. Some require the prescriber to give more specific details such as “bottle” mapping to “mL.” This requires the prescriber to specify the exact volume based on the anticipated patient need and length of treatment. In some cases, there are multiple acceptable units depending on the particular medication. For example, “container” may be appropriately mapped to “gram, milliliter or each” depending on whether it is a medication which is based on weight, volume or is a “self-contained” container. 

Efforts will be made to map to acceptable terms when possible. For example, when there is a “self-contained” unit (tube, bottle, inhaler) mapping to the generic “each” is considered best practice. When there are multiple smaller units (vial, ampule, tampon) the generic “unspecified” is felt to be the most appropriate. Prescribers are always welcome to add more specificity regarding quantity amounts and units (such as specific mL instead of each to a prescription that had previously been 1 bottle, or specific grams for a prescription that had previously been 1 tube.) This can be done in saved favorites or as each prescription is written, edited and reviewed. 

However, prescribing medication requires a medical license. Office Practicum Support and team members are not permitted by licensure regulations to suggest mapping for individual medications. Prescribing medications is ultimately the provider’s responsibility. Regardless of whether a prescription is written from the Master List or is a saved favorite and whether printed or sent electronically, appropriate edits and changes must be implemented and verified by the prescriber prior to final disposition.

NCPDP Sunsetted ValuesNCPDP Equivalent Billing Unit
ampuleMilliliter or Each
applicatorfulGram or Milliliter
bagGram or Milliliter
barEach
beadGram
blockEach
bolusMilliliter
bottleMilliliter
boxGram or Milliliter or Each
canGram or Milliliter or Each
canisterGram or Milliliter
cartonGram or Milliliter or Each
cartridgeMilliliter
caseGram or Milliliter or Each
cassetteGram or Milliliter or Each
containerGram or Milliliter or Each
cylinderGram or Milliliter or Each
deviceEach
diskEach
dose packGram or Milliliter or Each
dual packGram or Milliliter or Each
fluid ounceMilliliter
frenchEach
gallonMilliliter
inhalationGram or Milliliter or Each
inhalerGram or Milliliter or Each
inhaler refillGram or Milliliter or Each
international unitNo NCPDP entry
intravenous bagMilliliter
kilogramGram
literMilliliter
mEqNo NCPDP entry
metric dropMilliliter
milliequivalentGram or Milliliter
milligramGram
millimeterEach
nebuleMilliliter
need free injectionMilliliter
ocular systemEach
ounceGram
packageGram or Milliliter or Each
paperEach
penNo NCPDP entry
pintMilliliter
pouchGram or Milliliter or Each
poundGram
pre-filled pen syringeMilliliter
puffGram or Milliliter
pumpGram or Milliliter
quartMilliliter
sachetEach
scoopfulGram or Milliliter or Each
sprayGram or Milliliter
syringeMilliliter or Each
tablespoonMilliliter
tabminderEach
tamponEach
teaspoonMilliliter
trayGram or Milliliter or Each
tubeGram or Milliliter or Each
unitNo NCPDP entry
vialMilliliter or Each

In order to assist with mapping units to more specific appropriate values, our medical directors are creating a resource for commonly used medications which will be shared  as soon as available.