Ozempic®– Bill It Right!
Ozempic® is an injectable used to improve glycemic control in adults with type 2 diabetes mellitus and is available as 2 mg in a 1.5 mL (1.34 mg/mL) pre-filled, disposable pen injector. Chart available on our eNewsline.
Ozempic® is dosed once weekly. The starting dose is 0.25 mg once weekly for 4 weeks, then increasing to 0.5 mg once weekly. If additional blood sugar control is needed after at least 4 weeks at 0.5 mg , the dosage may be increased to 1 mg once weekly. Due to the confusing billing units (mL) and titration schedule, billing can be challenging. Based on how each patient responds to treatment and their goals, there are a few different clinical scenarios that may occur following the initial 4 weeks on 0.25 mg. See our eNewsline for three patient scenarios.
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PAAS Tips:
- The NCPDP billing unit is “mL” so the 1-pen box is billed as 1.5 mL and the 2-pen box is billed as 3 mL
- Submitted days’ supply should be in weekly increments based on the calculations
- After first use, the pens can be stored at room temperature for 56 days
I have a Bachelor of Science degree from the University of Wisconsin-River Falls and have been a Certified Pharmacy Technician since 2001. Prior to joining the PAAS team, I was a floating technician, 3rd party district chargeback specialist, and district pharmacy training coordinator. Formerly, I was also an instructor for pharmacy technician certification classes.
PAAS’ personal, one-on-one connection will help your pharmacy become more successful in dealing with tiresome PBM audits. It is a pleasure knowing that my colleagues and I can help member pharmacies.
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