Newsline No. 33-12  
July 2, 2012  

DWC posts list of National Drug Codes affected by the temporary unavailability of updates to pharmaceutical fee schedule data

The Department of Health Care Services (DHCS) has informed the Division of Workers' Compensation (DWC) that it has completed the update to the pharmaceutical price file that was necessitated by the unavailability of First Data Bank Average Wholesale Price. DHCS has prepared a list of those national drug codes (NDCs) that were affected during the period when the prices were unavailable. DWC has posted a spreadsheet on the pharmaceutical fee schedule webpage which lists NDCs that were new (sheet one), or that had pricing changes (sheet two), that took effect during the period of Sept. 1, 2011 through March 14, 2012.

Beginning May 23, 2012, the weekly pharmaceutical fee schedule data file and price calculator on the DWC website included all of the updates. DWC suggests that workers’ compensation providers examine the NDC list and, if warranted, resubmit pharmaceutical bills that were affected by the unavailability of price updates, and recommends that payers issue payments as appropriate. Payers and providers may consider whether there are contracts in place that may impact the need to re-process bills and issue corrected payments.