Auditors Are Drawn to Santyl® Like Moths to a Flame

a specialized online calculator developed by the ointment’s manufacturer to aid in appropriate dosing calculations and dispensing. When the ointment is being used for a chronic wound, prescriptions for Santyl^® must include the wound length and width (in centimeters) and the treatment duration to appropriately utilize the online calculator. When prescribed for a burn, the total body surface area and number of applications is required. Prescriptions missing applicable measurements will be flagged for non-calculable directions and will face full recoupment. Auditors are drawn to these scripts because they are high dollar claims and prescribers, and pharmacy personnel, often forget to include or obtain the measurements. Without this critical information documented, the claim will meet its demise upon audit.

Another pitfall to avoid with Santyl^® ointment claims is the inherent rounding with the online calculator that could inadvertently cause the pharmacy to bill an incorrect days’ supply. The dosing calculator rounds UP to the nearest tube size (packed as 30 or 90 grams), therefore, the true days’ supply must be calculated by the pharmacy to ensure you are not dispensing more medication than what is needed.

Example Wound Calculation:

Wound dimensions in centimeters and the duration of therapy = 6 cm x 2 cm for 30 days

• Manufacturer calculator results indicate a total of 62 g would be needed, and it suggests dispensing 90 g total
• The patient would need 3.6 cm per application if dispensing the 90 g tube (or 6.2 cm per application for the 30 g tube due to the tube opening diameter difference)
• The calculation details state 1.78 cm = 1 g for the 90 g tube size
• 90 g x 1.78 cm/g = 160.2 cm in the 90 g tube
• 2 cm / 3.6 cm = 44.5 days’ supply
• If the pharmacy were to dispense the 90 g tube for a 30-day supply, they would be dispensing too much medication

The pharmacy should dispense two 30-gram tubes in this example

• The 30 g tube needs 6.2 cm per application (tube opening is smaller than the 90 g tube)
• The calculation details state 3.04 cm = 1 g for the 30 g tube size
• 30 g x 3.04 cm/g = 91.2 cm in the 30 g tube
• 2 cm / 6.2 cm = 14.7 days’ supply
• Therefore, two 30 g tubes = 29.4 days’ supply

The SIMPLEST Method

The calculation method above is accurate, but also time consuming! The simplest method for calculating the correct quantity and days’ supply for Santyl^® for a chronic wound is utilizing the PAAS National^® Rx Days’ Supply Calculator app! The wound(s) dimensions are still required but the user-friendly interface has been designed to enhance efficiency and empower pharmacy staff with confidence. The PAAS Rx Days’ Supply Calculator app eliminates the inherent rounding issue seen with the manufacturer’s calculator and provides precise calculations.

Rather than getting zapped with a recoupment, be prepared; have all the appropriate documentation accounted for at the time the claim is billed and bill for an accurate days’ supply. When audited, the claim has a higher probability of passing with no discrepancies and sending the auditor buzzing off with zero recoupment.

PAAS Tips:

• Add a flag to the 30 g (NDC 50484-010-30) and 90 g (NDC 50484-010-90) tubes of Santyl® ointment in your pharmacy software system reminding pharmacy staff to review the prescription for the wound length and width (in centimeters) and treatment duration
• If more than one wound is being treated, be sure measurements and the treatment duration for each wound is documented
• Consider revaluating wound measurements periodically as the wound is (hopefully) decreasing in size during the course of therapy
  • Contact the prescriber’s office and obtain a new prescription if the wound size has changed
  • Plug in the new measurements into the PAAS Rx Days’ Supply Calculator app or Santyl® online calculator and bill for the appropriate quantity and days’ supply
  • Note: the Santyl® calculators will only allow a 30-day maximum duration of therapy, likely to reiterate the importance of wound revaluation
• For the treatment of a burn, only the Santyl® manufacturer’s online calculator can be utilized for determining the appropriate quantity; just remember to back-calculate the correct days’ supply by following the method outlined above
• Download the PAAS Rx Days’ Supply Calculator app for a free 7-day trial ($5.99/year thereafter) by visiting the Apple App Store or Android Google Play Store, or check out the website at com/app