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 Values||NCPDP Equivalent Billing Unit|
|ampule||Milliliter or Each|
|applicatorful||Gram or Milliliter|
|bag||Gram or Milliliter|
|box||Gram or Milliliter or Each|
|can||Gram or Milliliter or Each|
|canister||Gram or Milliliter|
|carton||Gram or Milliliter or Each|
|case||Gram or Milliliter or Each|
|cassette||Gram or Milliliter or Each|
|container||Gram or Milliliter or Each|
|cylinder||Gram or Milliliter or Each|
|dose pack||Gram or Milliliter or Each|
|dual pack||Gram or Milliliter or Each|
|inhalation||Gram or Milliliter or Each|
|inhaler||Gram or Milliliter or Each|
|inhaler refill||Gram or Milliliter or Each|
|international unit||No NCPDP entry|
|mEq||No NCPDP entry|
|milliequivalent||Gram or Milliliter|
|need free injection||Milliliter|
|package||Gram or Milliliter or Each|
|pen||No NCPDP entry|
|pouch||Gram or Milliliter or Each|
|pre-filled pen syringe||Milliliter|
|puff||Gram or Milliliter|
|pump||Gram or Milliliter|
|scoopful||Gram or Milliliter or Each|
|spray||Gram or Milliliter|
|syringe||Milliliter or Each|
|tray||Gram or Milliliter or Each|
|tube||Gram or Milliliter or Each|
|unit||No NCPDP entry|
|vial||Milliliter 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.