Pharmacy Disease Management Documentation Requirements

Pharmacy Disease Management Documentation Requirements In addition to the documentation requirements applicable to all pharmacy providers, pharmacy disease management providers must maintain additional documentation. The disease management pharmacist must maintain at his/her place of business proof of current certification for the specific disease state for which reimbursement is sought. A pharmaceutical care record, or patient record, must be maintained on each individual beneficiary for whom services are billed. These records must be retained and maintained in a manner conducive to audit, in alphabetical order and for a minimum of five (5) years. At a minimum, the following documents must be maintained, in date order, within each individual beneficiary’s pharmaceutical care record: A. A referral from the beneficiary’s physician/nurse practitioner, B. A copy of the protocol in accordance with the National Clinical Practice Guidelines authorizing pharmacy disease management of the beneficiary, C. Documentation of all oral and written communication with the beneficiary’s physician/nurse, D. Copies of all laboratory data provided, and E. All pharmacist notes, including progress reports, pertaining to the care of the beneficiary.