Representing Patient Medications

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Type Standard / Implementation Specification Standards Process Maturity Implementation Maturity Adoption Level Federally required Cost Test Tool Availability
Standard
Final
Production
Rating 5
Yes
Free
N/A
Standard
Final
Production
Rating 4
Yes
N/A
Limitations, Dependencies, and Preconditions for Consideration Applicable Value Set(s) and Starter Set(s)
  • RxNorm is often used for the exchange of information; however, it may not be available for export and import by end users.
  • The use of NDC in conjunction with RxNorm can help minimize gaps in representing medications, including compounded products, over -the-counter medications, and herbals.
  • Immunizations are not considered medications for this interoperability need.
  • Grouping Value Set: Medication Clinical Drug 2.16.840.1.113762.1.4.1010.4
    • Medication Clinical General Drug (2.16.840.1.113883.3.88.12.80.17)
    • Medication Clinical Brand-specific Drug (2.16.840.1.113762.1.4.1010.5) (RxNorm).
  • Grouping Value Set: Clinical Substance 2.16.840.1.113762.1.4.1010.2
    • Medication Clinical Drug (2.16.840.1.113762.1.4.1010.4) (RxNorm )
    • Unique Ingredient Identifier - Complete Set (2.16.840.1.113883.3.88.12.80.20) (UNII)

Comment

NCPDP - Comments - Not applicable to 2018 edition

The National Drug Code (NDC) should have an Adoption Level of 5 and Federally Required should be a Yes. It is mandated under HIPAA.

SNOMED is not currently used. NCPDP Standards would need to be modified to support SNOMED.

Medication Reference Terminology (MED-RT) is not currently used.  NCPDP Standards would need to be modified to support MED-RT.

NDC Federally Required and Adoption level

Thank you for your comments.  We acknowledge the federal requirement to include NDC on CMS 1500 claim form.  With respect to adoption level, we would appreciate  your comments on level of adoption and use of NDC within existing health IT systems.

UOM and VSAC

Medications category should include code system for unit of measure to be complete (UCUM).  A defined and limited value set of medication units of measure should be identified and available in VSAC

RxNorm is a good choice…

RxNorm is a good choice. Hadn't realized that NDC was federally required. Ideally there would not be a choice of sending either RxNorm OR NDC because that would break interoperability. If both are sent that would be OK.

NCPDP Comment

  1. Please remove previous NCPDP comments from 2017, as they no longer apply.
  2. NDC Adoption level is 5 since it is mandated by HIPAA.