Prescription returns

Prescription returns

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Approximately 0.16% of prescriptions are returned by the Pricing Authority to pharmacy teams each month for clarification. The majority of these prescriptions are returned because of insufficient or unclear endorsements.

To try and help reduce the number of returned items, we have compiled a list of common issues for pharmacy staff to be aware of (Please Note: this list is not exhaustive).

How to avoid returns

Issue

Examples of the problem

How to avoid it

A branded product is marketed by multiple suppliers Dianette tablets are manufactured by Bayer Plc but are supplied to Mylan under third party livery. When a prescriber issues a branded prescription for Dianette tablets, a pharmacist can dispense either the Bayer or Mylan product.

Endorse the name of the supplier as per the packaging. Click here for a list of products known to be affected by this issue.

Please note: If the prescription is resubmitted without the required endorsement, reimbursement will be made based on the branded product with the lowest price  (as per Part II Clause 7C of the Drug Tariff).

Generic prescription for inhalers which include a trademarked name e.g. Accuhaler or Easibreathe
  • Fluticasone propionate 100micrograms/dose dry powder Accuhaler
  • Beclometasone 100micrograms/dose breath actuated Easi-Breathe inhaler
The pharmacy should dispense the proprietary product which meets this description and endorse the prescription accordingly.
No pharmaceutical form listed on the prescription
  • Paracetamol 120mg/5ml sugar-free – this could be requesting either oral solution or suspension
  • Metronidazole 200mg PO – this could be requesting either tablets or suspension

Speak to the prescriber to confirm the form to be supplied and endorse the prescription accordingly using the “PC” endorsement.

Please note: If a Schedule 2 or 3 Controlled Drug prescription item has no form, this must be returned to the prescriber for amendment.

Total quantity not stated but clear from dosage instructions A prescription which states ‘Take 1 tablet TDS for one week’ but does not include a total quantity.

Endorse the total quantity dispensed.

Please note: If a Schedule 2 or 3 Controlled Drug prescription item has no total quantity stated, this must be returned to the prescriber for amendment.

Endorsement of non-Part VIIIA generic products  A prescription calls for Diltiazem 120mg modified-release capsules and Adizem was dispensed against this; the endorsement will need to specify whether Adizem-SR or Adizem-XL capsules are being dispensed as both meet this generic description. Endorse the following information:

  • pack size used to dispense from;
  • brand name or the name of the manufacturer or supplier from whom the product was purchased;
  • if the product is less common, the purchase price before discount (ex VAT).

What do the codes on my returned prescriptions actually mean?

When a copy of a prescription is returned to a pharmacy for clarification, payment is only delayed for the product(s) identified. All other products on the form have already been processed and reimbursed as usual. The form will specify which item number has been referred back for additional endorsement information. The following table explains what these return codes mean:

Endorsement required

Return code (these all start ‘RB’ for “referred back”)

1A 1B 1C 1D 1E 2A 2B 2C 2D 2E 3A 3B 3C 3D 3E 4 5
Supplier or manufacturer Button-Ok-icon Button-Ok-icon Button-Ok-icon N/A
Pack size used (e.g. 28/56) Button-Ok-icon Button-Ok-icon
Basic price per pack, ex. VAT Button-Ok-icon Button-Ok-icon
Type of liquid Button-Ok-icon
Presentation Button-Ok-icon Button-Ok-icon
Strength Button-Ok-icon Button-Ok-icon
Quantity dispensed Button-Ok-icon Button-Ok-icon Button-Ok-icon Button-Ok-icon
Product name Button-Ok-icon
Size (length or width) Button-Ok-icon Button-Ok-icon
DT catalogue number Button-Ok-icon Button-Ok-icon
Type of appliance Button-Ok-icon Button-Ok-icon
Size of vial, ampoule or cartridge Button-Ok-icon
1A 1B 1C 1D 1E 2A 2B 2C 2D 2E 3A 3B 3C 3D 3E 4 5

Resubmitting returned prescriptions

Photocopied prescriptions returned to contractors for further information contain a reference code. From this code, it is possible to determine the form type and whether the form was considered exempt from the prescription charge or charge paid. Where the patient is exempt there is also an indication of the reason why the patient was considered exempt. For example, from the reference code ‘FP10D E B’ on a returned photocopy, it is possible to tell:

  • the prescription form type, in this case an FP10D dental prescription
  • the exemption status, in this case, the ‘E’ indicates the prescription was considered exempt from the prescription charge. Prescriptions that are considered ‘Charge Paid’ will show the letter ‘C’
  • the patient’s exemption group, in this case, the ‘B’ indicates that the patient was exempt from the prescription charge because they were 16, 17 or 18 years of age and in full time education.

Exemption Group Reference Codes:

A  is under 16 years of age
B  is 16, 17 or 18 and in full time education
C  is over 60 years of age
D  has a valid maternity exemption certificate
E  has a valid medical exemption certificate
F  has a valid prescription pre-payment certificate
G  has a valid War Pension exemption certificate
L  is named on a current HC2 Charges Certificate
X  was prescribed free-of-charge contraceptives
H  gets income support
K  gets income based Jobseeker’s Allowance
M  is entitled to, or named on, a valid NHS Tax Credit Exemption Certificate
S  has a partner who gets a Pension Credit Guarantee Credit
Z  exemption status not captured

When resubmitting in the next month’s prescription bundle, these returned forms should be sorted at the top of the ‘exempt’ or ‘charge paid’ group as appropriate. The number of returned forms and items being resubmitted should also be declared, in the relevant boxes on Part 1 of the FP34c Submission Document.

Please remember only the number of items returned for clarification where payment has been delayed should be declared on the submission document. This is because payment will already have been received for any other items on the returned forms.

Disallowed prescriptions

Copies of prescriptions returned marked as ‘disallowed’ let pharmacy contractors know if an item has not been passed for payment by the Pricing Authority as it is not permitted on an NHS prescription. These copies can be used as learning opportunities for pharmacy staff to help prevent future disallowed items.

Guidance on whether a particular product can be dispensed on an NHS prescription is available from the Pricing Authority’s helpdesk (0300 330 1349) or from the PSNC Dispensing and Supply Team info@psnc.org.uk or 0203 1220 810.

Where a copy of a prescription has been returned incorrectly marked as ‘disallowed’, it should be returned to the Pricing Authority with the normal monthly prescription submission. The resubmitted item should be placed on the top of the bundle and clearly marked “Pricing Authority Error – resubmitted for reimbursement” (or equivalent).

PSNC closely monitors problems with copies of prescriptions being returned for clarification incorrectly. Please report suspected incorrect returns to the PSNC Dispensing and Supply Team who will ensure that this is fed back to the Pricing Authority.

 


Related Resources

EPS returns

Payment Factsheet 3 – Prescription Returns

Branded products known to be marketed by multiple suppliers

Daily Dispensing Checks

Sorting You Prescriptions Prior to Submission

Completing Your FP34c Submission Document and Dispatching Your Prescription Bundle

Monthly Payments

Prescription Pricing Accuracy

Digital Prescription Returns

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