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What is NCPDP D.0?

April 26, 2017d.0 NCPDP

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What is NCPDP D.0?

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The National Council for Prescription Drug Programs (NCPDP) maintains requirements regarding the standard way pharmacy claims must be transmitted. Telecommunications Standard Version D.0 is an updated version of the Health Insurance Portability and Accountability Act (HIPAA) standard for pharmacy claims transactions. It is an online, real-time conversation of a request from the pharmacy to the health plan AND a response from the health plan to the pharmacy. HIPAA X12 Version 5010 is a new set of standards that regulate the electronic transmission of specific healthcare transactions, including eligibility, claim status, referrals, claims, and remittances. Covered entities, including pharmacies, are required to conform to HIPAA 5010 standards and upgrade to NCPDP D.0 in order to support current pharmacy service transactions no later than January 1, 2012.