Home Forums Discussions General Discussion Pharmacy DAW Codes

Weird after 11 years or so with Amazing Charts. I had no idea about Dispense As Written as they pertain to codes. In the past couple of years, I have always been under the assumption tha to ensure a pharmacist used the brand name, you had to write Name Brand Medically Necessary. The DAW didn't count. But, there are nine codes all having a different meaning to a pharmacist.

DAW 0 is very weak in that it basically tells the pharmacist he or she can do whatever he or she pleases. DAW is basically the same thing, and in Maine certainly doesn't force the pharmacist to write for the drug on the script. Sometimes DAW 0 will turn into DAW. More later. I used to like DAW, because it fit nicely in the little box when you click on DAW, which gives you DAW in the box, which would make sense since it says DAW. Of couse, you can make it say anything you want in the admin section. I would love to put Name Brand Medically Necessary, but it doesn't fit. Now, there are all sorts of ramifications to this. If the prior authorization is for the generic only, so you want to have the phamacist make it the generic and not just run the brand name through Medicaid's computer and have it turned down. Or worse and a bit ironic, is when they brand name is covered but the generic is not. If you don't put DAW, they are required to use the generic name, which will not go through. So, you should have put in DAW 0 or DAW, but as we have seen, neither do anything so the pharmacist would still likely choose the generic.

But, here is the STRANGE part, and even moreso, since I would have thought that a lot more of my scripts would have been brand name.

Not sure how many people know this but when you use DAW on your script and print it out, it was saw DAW, which is what you would think. But, when you ePrescribe it, the pharmacist sees DAW 1. Don't ask me why. I learned this over a prior authorization question when the pharmacist took the covered hydroxyzine and made it Atarax, and it didn't go through. I am not sure why DAW was even on there, but it came out on the script as DAW 1 when he faxed it back, since I have never heard of DAW 1, I know I didn't write it. But, sure enough it did.

One one script, DAW came out DAW, but on the ePrescribed script, it said, "Name Brand Medically Necessary. We have changed DAW to DAW 1 in AC, so now when we click on DAW, it will go as DAW 1. But, who knows, maybe it will change to DAW 2. DAW 2 is a weird one in that neither the pharmacist nor we have any say over the Brand name, etc. It is up to the patient. But, it still may cost them more or the insurance company may not cover it once they hear the DAW code from the pharmacist. Insurance companies tend not to allow their customers to have any say in the matter.

But, when you Google them, they don't make a lot of sense. But, if you take nothing away from this long post, it should be that at least with 6.1.2, DAW is converted to DAW 1 in cyberspace.

http://tinyurl.com/k33fjwo

Agree with Bert. I thought that Dispense As Written was pretty clear what it meant. Another example of corporate entities usurping physician prerogatives (for economic reasons of course). I always tell the Medco jerk-clerks (when they overrule my requests for specific drugs), that I hope they understand that their decision carries risks & consequences. I guess that $185 million dollars they paid to settle a DOJ health care fraud suit in 2010 didn't make much of an impression.

Made that way too difficult. Basically, my DAWs on the ePrescribe scripts are turning into DAW 1s on the pharmacy side. Which would be cool if either AC (doubtful) or NewCrop/Surescripts automatically converted them knowing the physician wanted DAW 1 in the first place.

I was hoping that someone else could verify that if you use DAW for Name Brand Medically Necessary if the pharmacy sees DAW 1 on ePrescribe.

Spoke to my pharmacist and this is her explanation:
My erx's marked "DAW" come across as "DAW". In order to enter the medication into her system, she has to put a number after the DAW.
DAW-1 means it is the doctor's choice.
DAW-2 means it is at the patient's request.

If I send nothing but "DAW" she believes that to mean it is at my request, so she codes it DAW-1.

Perhaps there is some variation based on the pharmacy's receiving system (i.e. maybe some automatically convert a plain DAW to DAW-1 since it can be assumed that the doctor is making the request).

This is useful information (the difference between DAW-1 and -2) but I don't think it changes the way I will send my DAW scripts.

I had an even stranger conversation with a pharmacist. I sent an Rx for, I think, Dexmethylphenidate, and the pharmacist called to state that it would be filled as Focalin (and not go through) unless I specifically stated it needed to be generic. She implied, but did not say, nor did question further at the time, that I needed to put DAW just to get generic.

That is interesting and makes more sense Jon. But, I think I will keep it DAW 1, because that completely means Name Brand Medically Necessary.

@Wendell That is just bizarre. I would take a look at the pharmacist's license, lol.

I would also suggest looking at the site above. There are more interesting codes.

Thanks Wendell and Jon. I appreciate the feedback.

The pharmacist I called today said he would never change a code. DAW 0 = DAW. DAW = DAW 0.

It is too bad NBMN wasn't an accepted acronym, because technically Name Brand Medically Necessary is the correct lingo.

If you were going to mean Pharmacist or doctor is correct, then leaving it blank makes the most sense. I suppose it doesn't matter as Obamacare will likely change it soon with a 60-page document.

In Florida, "Brand Medically Necessary" is the official designation for DAW. Unfortunately the PBMs like ExpressRx & OptumRx are out of state, so we Florida docs have to learn the DAW system also. It's no surprise that the PBMs are located in NJ & AZ -- apparently in those states they can ignore physician orders with immunity.

You're lucky. Not to sound like a broken record, but I just changed my default to DAW 1.

I don't know why anyone would go to the bother of putting DAW 0. DAW 2 is interesting as neither the physician or pharmacist makes the decision. The patient can decide but often at a price.