VA CCN September 2026 Provider Pulse

VA Now Accepts Electronic Prescriptions: What to Know

VA now accepts electronic prescriptions from community providers. This is valid for all eligible Veteran medications, including controlled substances such as opioids and stimulants. When doing an electronic prescription, use the VA pharmacy’s published name, typically the town where the pharmacy is located, followed by “VAMC Pharmacy” (i.e., Buffalo VAMC Pharmacy).

VA will still accept/fill paper prescriptions (or fax, where applicable). However, electronic is now the preferred method due to ease-of-use and state regulation compliance. Consult the Prescribing Medications portion of the Veteran Care section of the VA website to learn more about prescription methods and view pharmacy resources.

VA Announces New Suicide Prevention Initiatives

TriWest is honored to support the VA with three pilot initiatives focused on suicide prevention. We have been conducting outreach to providers and organizations in key designated areas within our region to recruit participant/providers for these important efforts. If you have received outreach and are interested in participating in these pilots, please follow through with the instructions in your personalized outreach.

The pilots and the regions are listed below.

• Suicide Prevention for Emergency Departments: Pilot underway in San Antonio, TX; Cheyene, WY; and Las Vegas, NV.
• Project Safe Guard: Suicide Prevention Training for Community Providers: Pilot underway in San Antonio, TX; Cheyene, WY; and Las Vegas, NV.
• Inquiry routing and information System: VA Direct Messaging: Pilot underway in Big Spring, TX; Harlingen, TX; and Prescott, AZ.

Precertification ID No Longer Required for Veteran Care

Effective Tuesday, September 8, 2026, the Department of Veterans Affairs (VA) no longer requires precertification before providing authorized care for Veterans.

The VA Precertification Portal (VAPP) is now offline.

Continue delivering care as authorized under the Veteran’s referral and Standard Episode of Care (SEOC). There will be no changes to claims processing or your payment.

This is a change to guidance previously provided in Provider Pulse.

Proper NDC Submission Helps Prevent Veteran Claim Denials

Review the National Drug Code Billing Guidelines

As a reminder, when billing claims with drug codes on a CMS 1500 form (professional), electronic 837P, UB-04 (institution) and/or electronic 837I, it is necessary to bill the NDC number, units and quantity correctly.

Professional Paper Claim Guidelines (CMS-1500)

In the shaded portion of the line-item field 24A-24G on the CMS-1500, enter the qualifier N4 (left-justified), immediately followed by the NDC. Next, enter one space for separation, then enter the appropriate qualifier for the correct dispensing unit of measure (UN, ML, GR, or F2), followed by the quantity (number of NDC units up to three decimal places), as indicated in the example below.

Institutional Paper Claim Guidelines (UB-04)

In the line-item field 42-43, enter the appropriate drug-related revenue code in field 42. In field 43, report the NDC qualifier N4 (left-justified), immediately followed by the 11-character NDC in the 5-4-2 format (no hyphens). Immediately after the last digit of the NDC, enter the appropriate qualifier for the correct package size, NDC unit of measure (UN, ML, GR, or F2), followed by the quantity (number of NDC units up to three decimal places), as indicated in the example below.

Include the N4 before the 11-digit NDC number, but do not include drug name on the claim form. If the drug name is included on the claim form, this may result in the claim being denied.

Drug claim lines submitted without a valid NDC or with an incorrect HCPCS/CPT and NDC combination will be denied.

VA CCN Provider Handbook Updates

There are no updates to the VA CCN Provider Handbook this month.