- Please refer to CMS.gov for more information regarding Medicare Part D electronic prescribing requirements and sign up to receive the latest announcements.
- Included in the Structured and Codified Sig Format of electronic prescribing transactions are elements, fields and values that are directly related to the prescriber's instructions for use.
- The following elements of the Sig are required when Structured Sig is sent:
- Code system
- Route Of Administration
- The following elements of the Sig are conditional (only required when prescriber specifies) when Structured Sig is sent:
- Site of Administration
- Maximum Dose Restriction
- The following elements of the Sig are required when Structured Sig is sent and when dose is to be calculated:
- Dose Calculation
- Used where a body metric such as metric weight (kg) or surface area (m*2) is used to calculate a dose for a patient.
- May often be used in conjunction with the Rate within TimingAndDuration and/or the Vehicle.
- The SCRIPT 2017071 Observation element in the NewRx transaction supports the use of a patient's height, weight and other vital signs:
- Inclusion of VitalSign (most recent patient's height and weight) and ObservationDate (YYYY-MM-DD height and weight observed/taken) is required for patients 18 years old and younger on all new and renewal prescriptions from a prescriber to a pharmacy.
- If the height and/or weight have changed and a prescriber is sending an approved renewal response, the response should be coded as Approved with Changes.
- ObservationDate is now mandatory when Observation Segment Measurement is sent.
- ObservationNotes may contain other pertinent information pertaining to weight-based calculations.
- It is recommended that developers adopt logic that results in a prescription that calculates a weight-based dose to suggest a measurable dose (e.g., rounded to the +/- 5-10% of the calculated dose). Measurable dose should be based on home dosing tool precision. For example, a weight-based dose calculation may result in instructions to give a child 4.7mL amoxicillin 400mg//5mL (375mg) when the measurable dose should be 5mL (400 mg is still a safe dose and easier to measure with a 5mL or 10mL oral syringe).
- Both the prescriber and the pharmacy must have their systems configured for the transaction in order to facilitate successful exchange, including the ability to send or receive verify, status, or error transactions.
- See NCPDP projects in the Interoperability Proving Ground.
LOINC 2.63 codes supporting SCRIPT 2017071 <Observation> segment: