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    STANDARDS - STANDARD CHANGES


  




BILLING UNIT STANDARD

What is the Billing Unit Standard? Click Here for a brief introduction.

DRUG MANUFACTURERS

The use of a standard for the assignment of billing units is critical in most aspects of drug claims--from the initial submission of a claim and Drug Use Reviews through the back-end rebates process. As new products and packaging are developed, it is important that manufacturers be aware of and stay consistent with the NCPDP Billing Unit Standard. NCPDP WG2 Product Identification has developed a document that provides a brief description of the standard. For a copy of the Billing Unit Standard Fact Sheet, Click Here.

Use the Billing Unit Decision Tree to help answer questions as to correct billing unit assignments. questions.
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Providers may use the Billing Unit Description to assist in identifying the correct billing unit for transactions.

PACKAGE SIZE DISCREPANCIES

Discrepancies among the compendia on different methods/policies for defining package size were identified by WG2. Such discrepancies would result in different unit costs or different billing units among the compendia causing potential billing/adjudication errors. A list of NDCs with package size discrepancies across the compendia was compiled, reviewed and a common package size assigned. A list of these items may be reviewed by clicking here. WG2 will continue to review any package size issues brought to its attention. Package size discrepancies should be sent to Patsy McElroy, pmcelroy@ncpdp.com.

QUIC

The purpose of the Quantity Unit Information Communication (QUIC) Forms is to:

  • Ensure the integrity of the billing standard.
  • Serve as a mechanism for the pharmacy community and NCPDP to communicate/document issues and resolutions which are BU related.
  • Guide the pricing compendia in data consistency.
  • A mechanism for the work group to track issues and a way of communication to the industry that their concerns will be addressed timely and efficiently.
The basic process for a QUIC Form is:
  • Submit an electronic QUIC form to the WG2 liaison office with accompanying information. Each QUIC form must be received thirty (30) days before the next work group meeting is scheduled.
  • Upon receipt, the WG2 liaison will notify the submitter of the assigned QUIC form number and provide the date that it will be reviewed.
  • The copy of the QUIC form request is sent to the Co-Chairs of WG2. The Co-Chairs will coordinate research on the request and the requestor will be contacted and the manufacturer (if different) directly with any questions. It is also placed in the member's only area of the website.
  • Work groups during quarterly meeting review the QUIC form. We strongly encourage submitters to attend the meeting to discuss your request.
  • After the work group meeting each QUIC form requestor will receive an e-mail from the WG2 liaison that will provide information on their request.
For a copy of the QUIC form and guidance information that will assist with its review, Click Here. To view the Standards Compliance Process, Click Here



Completed QUIC Forms in


Old-New order: 
201001 Lidocaine/Prilocaine Cream NDC: 00168-0357-56
201003 Cayston NDC: 61958-0901-01
960002 FDA and HCFA Package Sizes
201002 Qutenza (capsaicin) 8 % Patch NDC: 49685-0928-01 & 49685-0928-02
960001 Billing Unit Discrepancies
960003 Nicorette (OTC Version) 2/4 mg
960004 Aldara 5% Imiquimod
960005 Avonex Administration Pack
970001 Metaproterenol Sulfate (Example)
970002 Fragmin (Dalteparin Sodium Injection)
970003 FRAGMIN (dalteparin sodium injection)
970004 Intron A
200308 Prestige Smart System
200309 Synalgos-DC
970005 Copaxone
970006 Lovenox 30mg prefilled syringe
970007 Lovenox 40mg prefilled syringe
970008 Desquam-X Bar 10% 3.75 oz.
970009 Monurol 3gm sachet
980001 HELIDAC
980002 Handling Multi-dose Iyophilized vial billing within the standard
980003 Infergen (Interferon alfacon-1)
980004 STIMATE
980005 Handling Multidose Iyophilized vial billing within the standard
980006 Lovenox 40
980008 Pedia-Pop Palsicles
990001 Prevpac Patient Pac
990002 Nicotrol Cartridge Inhaler
990003 Relenza
200310 Amevive 15 mg 4 dose
990004 Vanceril DS Convenience
990005 Lovenox
200001 Videx Pediatric Solution
200002 Lovenox
200003 Pulmozyme
200004 Neupogen
200101 Derma-Smoothe FS Atopic Pak
200202 Infuvite
200203 M.V.I. 12
200204 Copaxone
200205 Bacitracin 5MMU Powder
200206 Colistin Sulfate Powder
200301 Ultra TLC
200302 Amevive 7.5mg 4 dose
200303 Biafine RE 46 ml
200304 Biafine RE 93 ml
200305 First-Hydrocortisone gel
200306 First-Testosterone cream
200307 First-Testosterone ointment
200401 Many Bulk Chemicals
200402 Duet DHA
200403 Follistim AQ - 437.5 units/05.25 ml
200404 Follistim AQ 737.5 units/0.885 ml
200405 Icar Prenatal
200406 Vfend
200407 Albuterol Sulfate Inhalation Solution
200408 Hytone 2.5%
200409 S2 Inhalant
200410 Androgel 1% Pump
200501 FIRST Progesterone VGS 100
200503 Rebif Titration Pack
200411 Diastat Rectal Gel
200412 Duet DHA Combo PK
200413 Pretty Feet and Hands
200414 Various Glucose Meter Control Solutions
200415 Octagam 5% Vial
200416 Pedialyte Freezer Pops
200417 Xolair
200504 Asmanex
200505 Ultiguard
200506 Twinject auto-injector
200507 ZMAX
200508 Sidekick
200509 Keralac Nailstik
200510 Diastat AcuDial Twin Pack
200511 Keralac Nailstik
200601 Efudex Occlusion
200602 Tretin X
200603 ZMAX
200604 Pulmicort Inhalers
200605 Exubera (Insulin for inhalation)
200606 Intron A injection
200607 Vaprisol
200608 Cleeravue-M
200609 Centary Kit
200610 INTRON A Solution for Injection in Multidose Pens
200611 MoviPrep
200612 Nystatin Powder
200613 AnaMantle HC Cream & AnaMantle HC Cream Kit
200614 Atridox
200701 ClindaReach
200702 Lucentis
200703 Pulmicort Flexhaler
200704 Euflexxa
200705 Torisel
200706 Duplex Delivery Systems
200707 Rinnovi Nail System
200708 Somatuline
200709 Coraz Lotion
200710 and 200711 SymlinPen
200801 Ceprotin
200802 RhoGAM
200803 SALICEPT SUS
200804 Salex Cream and Lotion
200805 Rowasa
200806 BREVOXYL
200901 Breze Kit
200807 NUTRIDOX CONVENIENCE KIT
200902 Vanoxide HC Lotion Kit
200903 and 200904 Welchol Powder
200905 NeoBenz Micro Plus Pac
200906 Lioresal Intrathecal
200907 Accutrend Cholesterol Control Solutions
200908 Ozurdex (dexamethasone intravitreal implant)
201004 Valcyte Oral Suspension NDC: 00004-0039-09
200909 Tyvaso Starter Kit and Tyvaso Refill Kit
201005 Prevalite® (Cholestryamine for Oral Suspension, USP) Powder NDC: 0245-0036-23 and 0245-0036-42 and 0245-0036-60
Alphabetical order: 
200907 Accutrend Cholesterol Control Solutions
200407 Albuterol Sulfate Inhalation Solution
960004 Aldara 5% Imiquimod
200310 Amevive 15 mg 4 dose
200302 Amevive 7.5mg 4 dose
200613 AnaMantle HC Cream & AnaMantle HC Cream Kit
200410 Androgel 1% Pump
200504 Asmanex
200614 Atridox
960005 Avonex Administration Pack
200205 Bacitracin 5MMU Powder
200303 Biafine RE 46 ml
200304 Biafine RE 93 ml
960001 Billing Unit Discrepancies
200806 BREVOXYL
200901 Breze Kit
201003 Cayston NDC: 61958-0901-01
200609 Centary Kit
200801 Ceprotin
200608 Cleeravue-M
200701 ClindaReach
200206 Colistin Sulfate Powder
200204 Copaxone
970005 Copaxone
200709 Coraz Lotion
200101 Derma-Smoothe FS Atopic Pak
970008 Desquam-X Bar 10% 3.75 oz.
200510 Diastat AcuDial Twin Pack
200411 Diastat Rectal Gel
200402 Duet DHA
200412 Duet DHA Combo PK
200706 Duplex Delivery Systems
200601 Efudex Occlusion
200704 Euflexxa
200605 Exubera (Insulin for inhalation)
960002 FDA and HCFA Package Sizes
200501 FIRST Progesterone VGS 100
200305 First-Hydrocortisone gel
200306 First-Testosterone cream
200307 First-Testosterone ointment
200403 Follistim AQ - 437.5 units/05.25 ml
200404 Follistim AQ 737.5 units/0.885 ml
970002 Fragmin (Dalteparin Sodium Injection)
970003 FRAGMIN (dalteparin sodium injection)
980005 Handling Multidose Iyophilized vial billing within the standard
980002 Handling Multi-dose Iyophilized vial billing within the standard
980001 HELIDAC
200408 Hytone 2.5%
200405 Icar Prenatal
980003 Infergen (Interferon alfacon-1)
200202 Infuvite
970004 Intron A
200606 Intron A injection
200610 INTRON A Solution for Injection in Multidose Pens
200511 Keralac Nailstik
200509 Keralac Nailstik
201001 Lidocaine/Prilocaine Cream NDC: 00168-0357-56
200906 Lioresal Intrathecal
200002 Lovenox
990005 Lovenox
970006 Lovenox 30mg prefilled syringe
980006 Lovenox 40
970007 Lovenox 40mg prefilled syringe
200702 Lucentis
200203 M.V.I. 12
200401 Many Bulk Chemicals
970001 Metaproterenol Sulfate (Example)
970009 Monurol 3gm sachet
200611 MoviPrep
200905 NeoBenz Micro Plus Pac
200004 Neupogen
960003 Nicorette (OTC Version) 2/4 mg
990002 Nicotrol Cartridge Inhaler
200807 NUTRIDOX CONVENIENCE KIT
200612 Nystatin Powder
200415 Octagam 5% Vial
200908 Ozurdex (dexamethasone intravitreal implant)
200416 Pedialyte Freezer Pops
980008 Pedia-Pop Palsicles
200308 Prestige Smart System
200413 Pretty Feet and Hands
201005 Prevalite® (Cholestryamine for Oral Suspension, USP) Powder NDC: 0245-0036-23 and 0245-0036-42 and 0245-0036-60
990001 Prevpac Patient Pac
200703 Pulmicort Flexhaler
200604 Pulmicort Inhalers
200003 Pulmozyme
201002 Qutenza (capsaicin) 8 % Patch NDC: 49685-0928-01 & 49685-0928-02
200503 Rebif Titration Pack
990003 Relenza
200802 RhoGAM
200707 Rinnovi Nail System
200805 Rowasa
200409 S2 Inhalant
200804 Salex Cream and Lotion
200803 SALICEPT SUS
200508 Sidekick
200708 Somatuline
980004 STIMATE
200710 and 200711 SymlinPen
200309 Synalgos-DC
200705 Torisel
200602 Tretin X
200506 Twinject auto-injector
200909 Tyvaso Starter Kit and Tyvaso Refill Kit
200505 Ultiguard
200301 Ultra TLC
201004 Valcyte Oral Suspension NDC: 00004-0039-09
990004 Vanceril DS Convenience
200902 Vanoxide HC Lotion Kit
200607 Vaprisol
200414 Various Glucose Meter Control Solutions
200406 Vfend
200001 Videx Pediatric Solution
200903 and 200904 Welchol Powder
200417 Xolair
200507 ZMAX
200603 ZMAX