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eRx Patient Safety Alert 

(Last Updated On: June 8, 2018)

When performing refills, if a prescriber intends to communicate other changes to a patient’s medication regimen (such as different drugs and drug identifiers, different administration directions, or different dispense quantities, etc.) and other fields need to be added or updated, then a “Denied New To Follow” status type REFRES transaction must be used instead. Any intended changes to other fields must be conveyed to the pharmacy via a separate NewRx transaction. Please see Surescripts full communication on the matter below:

Date: May 30, 2018

Subject: Compliance reminder regarding potential patient safety risks – Clinically-significant changes to REFRES transactions

Details: As outlined in our Application Certification Requirements (section 3.9 RES – Response Segment), Surescripts mandates that only certain fields can be added or updated in “Approved with Changes” status type Refill Renewal Response (REFRES) transactions. The purpose of this requirement is to ensure prescriber intent is clear by avoiding data field mismatches or conflicting information in a single prescription message.

If a prescriber intends to communicate other changes to a patient’s medication regimen (such as different drugs and drug identifiers, different administration directions, or different dispense quantities, etc.) and other fields need to be added or updated, then a “Denied New To Follow” status type REFRES transaction must be used instead. Any intended changes to other fields must be conveyed to the pharmacy via a separate NewRx transaction.

The only fields that can be added or updated in “Approved with Changes” status type REFRES transactions include:

  • Prescriber NPI (PVD-020-01)
  • DEA# (PVD-020-01)
  • SSN (PVD-020-01) with the military specialty ID (PVD-040-03)
  • Prescribing Agent (PVD-100)
  • Prescriber Address (PVD-080)
  • Supervisor Segment (PVD SU)
  • Refills Qualifier (DRU-060-01)
  • Number of refills (DRU-060-02)
  • Date Written (DRU-040)
  • Diagnosis (DRU-070)
  • Prior Authorization (DRU-080)
  • Drug Use Evaluation (DRU-100)
  • Observation Segment (OBS)

Response: All EHR vendors should remind their end-user prescribers of this requirement. If you have any questions, please contact your Surescripts Account Manager or Surescripts Customer Support at support@surescripts.com.

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