The new 5010 claim standard is driving new requirements in drug reporting, specifically for drug quantity and the unit of measure.

Jackie Griffin, manager of training and project implementation at Gateway EDI, listed one of the Top 5 Potential HIPAA 5010 Rejections to be drug quantity,

“If you submit a National Drug Code (NDC) on the line of service for injectable medications, HIPAA 5010 requires that the drug quantity be reported. The unit of measure must also be submitted on the claim file in addition to what you already send on service lines, including the HCPCS code, the total charge and units of service.”

Some practices use White Plume products to enter this information before transferring it to their practice management system. Practice management systems may have new requirements concerning the information necessary for the claim to be filed correctly. Those practices affected will need to contact their practice management system as well as White Plume Technologies to discuss the options for entering this information.

Practices should determine whether or not they are required to include NDC information, and on what claims, then review the 5010 FAQ and Tips from Gateway EDI.