What does DAW 1 signify in pharmacy billing?

DAW 1 indicates that the prescriber has specified that a brand-name medication must be dispensed and that generic alternatives are not allowed. This code is crucial in the pharmacy billing process as it communicates to insurance providers that the prescriber has intentionally decided against allowing generics for that specific prescription, often due to therapeutic equivalence concerns or unique characteristics of the brand product that are deemed necessary for the patient's treatment.

When billing with a DAW 1 code, the pharmacy can ensure appropriate reimbursement for the brand product, reflecting the prescriber's intent. This designation helps prevent misunderstandings regarding medication dispensation and reimbursement, as it lays clear the prescriber’s directive regarding the preferred product.

The other options imply varying scenarios around generic versus brand product dispensation. However, they do not accurately capture the full meaning of DAW 1. For instance, a situation where generic substitution is permitted but the patient opts for a branded product would be labeled differently, and similarly for other codes. Thus, the understanding of DAW 1 remains specific to the prescriber's explicit instruction against substituting a generic.