1. Billing Unit Change for Discovisc and DuoVisc

    The following intraocular products are currently listed with a billing unit of “each”, but will be listed with a billing unit of “mL” by the Drug Compendia effective with each compendium’s end of quarter files of April 1, 2016. 

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  2. CAQH CORE 2015 MBR Industry-wide Submission Period

    The CAQH® Committee on Operating Rules for Information Exchange (CORE®) launched the industry-wide submission period for the 2015 Market-based Review (MBR) of the CORE-required Code Combinations for the CORE-defined Business Scenarios.

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  3. SPAP ADAP BIN PCN Spreadsheet

    NCPDP manages a listing of all State SPAPs and ADAPs. This list can be used by Part D sponsors in reconciliation efforts along with managing TrOOP for their beneficiaries. SPAP ADAP BIN PCN Spreadsheet

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  4. MACRA Legislation Requirement

    The NCPDP WG1 Definition of a Valid Prescriber Task Group has been working with CMS to develop the appropriate point of service communication that should occur as a result of MACRA legislation Section 507. Effective January 1, 2016, this legislation requires all Medicare Part D claims contain an active and valid Type 1 NPI as the prescriber identifier. Please refer to the Collaborative Workspace (Question D45 within the task group’s FAQ document) for the task group recommendation that will be presented in February 2016.

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  5. October 2015 CORE Code Combinations v3.2.1 Now Available

    The October 2015 updated version of the CORE-required Code Combinations for the CORE-defined Business Scenarios (CORE Code Combinations) is now available for use with the CAQH CORE 360: Uniform Use of CARCs and RARCs Rule. This version includes Compliance-based Adjustments as a result of code list updates published on July 1, 2015.

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