NCPDP developed and maintains the Billing Unit Standard (BUS) – the “billing quantity language” for pharmacy transactions. The guiding principle behind the BUS is that the quantity for every drug product can be described as a number of "eaches" or "grams" or "milliliters."
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 Work Group 2 (WG2) Product Identification has developed a fact sheet that provides a brief description of the standard. Manufacturers should use the Billing Unit Decision Tree to help answer questions or determine correct billing unit assignments. It may also be helpful to consult the QUIC Form Resolutions for difficult-to-classify products that have been clarified.
Package Size Discrepancies
Sometimes there are discrepancies among the drug compendia on different methods/policies for defining package size. This can result in billing and adjudication errors. NCPDP’s WG2 compiled a list of NDCs with package size discrepancies across the compendia, reviewed and aligned them with the billing unit standard. WG2 continues to review package size discrepancies brought to its attention. Please send package size discrepancies to Sandra Garnand at firstname.lastname@example.org.