New Tools Available! Biologic and Non-Biologic Injectable Medication Reference Charts
Ever wonder if you were billing the correct NDC for a Humira® prescription and had to spend precious time investigating? Or how about questioning if you were billing the correct package size for Gvoke® and had to consult multiple references just to try and figure out the answer? Perhaps you had audit on Ajovy® only to find your pharmacy facing recoupment because the auto-injector was billed but the script was written for the pre-filled syringe.
PAAS National® now has two new reference charts available to help you and your staff with billing these unique injectable products correctly. Check out the Biologic Injectable Medication Chart and Non-Biological Injectable Medication Chart under the Tools & Aids section of the PAAS Member Portal.
PAAS Tips:
- Utilize the Biologic Injectable Medication Chart to:
- Determine if there is an interchangeable biologic available in the marketplace
- Cross reference the correct NDC for medications such as Humira® and Enbrel®
- Review the available dosage forms for medications such as Simponi® and Emgality®
- Verify the correct NCPDP billing unit for medications such as Cimzia® and Aimovig®
- Utilize the Non-Biological Injectable Medication Chart to:
- Review the available dosage forms for medications such as Abilify Maintena® and Gvoke®
- Verify the correct NCPDP billing unit for medications such as Lovenox® and Xyosted®
- Find USP guidance for the expiration date of multi-dose vials (not otherwise indicated by the manufacturer)
- These injectable medications carry a high audit risk; billing the correct formulation, quantity, NDC and days’ supply is not only essential to receiving the appropriate payment at time of adjudication but also necessary to successfully pass an audit
- Check out the Tools & Aids tab on the PAAS Member Portal for additional reference charts which have been skillfully and deliberately crafted to save pharmacy staff time and money; print these and post them near the pharmacy claims processing station for easy reference
I enjoy assisting pharmacy staff both pre- and post-audit and enjoy providing them with knowledge and tools to decrease audit risk going forward. I write articles for Third-Party Newsline each month and answer member questions daily. I look forward to building professional relationships with each of our members and assisting you with your next audit.
