Electronic Prescribing
Electronic prescribing (e-prescribing) is the transmission of prescription or prescription-related information through electronic media. E-prescribing takes place between a prescriber, dispenser, pharmacy benefit manager (PBM) or health plan. It can take place directly or through an e-prescribing network. With e-prescribing, health care professionals can electronically transmit both new prescriptions and responses to renewal requests to a pharmacy without having to write or fax the prescription.
E-Prescribing for Part B Drugs
* Reviewers will accept as a valid order any Part B drugs, other than controlled substances, ordered through a qualified E-prescribing system. For Medicare Part B medical review purposes, a qualified E-prescribing system is one that meets all 42 CFR 423.160 requirements.
* Reviewers will accept as a valid order any drugs “incident to” Durable Medical Equipment (DME), other than controlled substances, ordered through a qualified E-prescribing system.
* When Part B drugs and/or drugs “incident to” DME, other than controlled substances, have been ordered through a qualified E-prescribing system, the reviewer will not require the provider to produce hardcopy pen and ink signatures as evidence of a drug order.
* When reviewing claims for controlled substance drugs, the reviewer will only accept hardcopy pen and ink signatures as evidence of a drug order.
