SureScripts Customer Bulletin

Limiting the Use of C38046 (Unspecified) and C64933 (Each) in the Potency Unit Code Field in All E-prescription Messages

 

Date:  June 1, 2015

Title: Limiting the use of C38046 (Unspecified) and C64933 (Each) in the Potency Unit Code field in all e-prescription messages

Purpose: To educate Surescripts technology partners on the importance of limiting the use of C38046 (Unspecified) and C64933 (Each) in the Potency Unit Code field as well as the Surescripts v10.6 application certification requirement (ACR) #106R-158.

Notes to Pharmacy

Description:  The National Council for Prescription Drug Programs (NCPDP) SCRIPT version 10.6 allows the transmission of a Potency Unit Code (PUC) to qualify the prescribed or dispensed quantity. This field uses the National Cancer Institute Thesaurus (NCIt) code set for Quantity Unit of Measure. For the most recent version of the NCIt code set please visit http://go.surescripts.com. The receipt of PUCs that are unspecific may cause workflow disruptions, physician callbacks for clarification, and/or potential patient safety risks.
 
It has been noted that PUCs sent by some technology partners are unspecific; most commonly the NCIt codes of C38046 (Unspecified) and C64933 (Each) are sent while more descriptive NCIt codes are available to be used instead to qualify the prescribed/ dispensed quantity. For example, Hydroxyurea 500 mg oral tablet may be sent with a quantity of 30 with a PUC of C38046 (Unspecified) rather than C48542 (Tablet). It is a best practice to send either the metric unit (e.g. Milliliter, Gram, etc.) or most descriptive PUC value when communicating a quantity in the e-prescribing message.
 
NCPDP recently published guidance for the use of these NCIt codes which is available in the NCPDP SCRIPT Implementation Recommendations v1.31 document which discourages the use of C38046 and C64933 unless they meet the following criteria:

"The Quantity Qualifier code value C38046 (Unspecified) is only to be used for translation purposes when a Quantity Qualifier value is not available for use in the version of the NCI Codes. Translation is the mapping process used when either converting between different versions of SCRIPT Standard, or when adopting these recommendations for the code set migration.

C64933 (Each) is only to be used for conveying specific units that do not meet the recommendations criteria identified, such as:

  • Measured in volume or weight.
  • Translated value is not available within the current version of NCIt.
  • Items without specific values in the current version of NCIt that would be expected to be measured in units of one/each
    • Examples: DME supplies, such as canes, wheel chairs, various braces or orthotics, etc. and other one-offs, such as a new device without a current NCIt value."

For additional guidance from NCPDP, please access http://go.surescripts.com.
 
Furthermore, Surescripts requires technology partners to associate NCIt values that correspond to the medication concept identified within the drug description field. Below is the Surescripts application certification requirement (ACR) that addresses the use of unspecific PUCs:
 
"Potency Unit/Quantity Qualifiers shall*106R-158 be correctly associated with drug descriptions."
 
It is important that the prescribed/ dispensed quantity of medication be unambiguous and clear. Therefore, in order to optimize workflow efficiency as well as improve patient care and safety, please ensure that your systems adopt and adhere to the guidelines explained above.

 

Please contact Surescripts with questions:

Mail Order Pharmacy
Prescriber Technology Vendor
Retail Pharmacy