PPA Coding & Claiming Best Practices (EMIS Focus)

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Deciding When to Use Practice Stock vs. FP10

Introduction

Getting the correct items at the right cost is only half the story of Personally Administered Items (PPA). If you don’t record and claim them properly in your clinical system, you’ll miss out on reimbursement - even though you’ve already paid for the stock. This article shows how to capture every PPA claim within EMIS Web, plus some best-practice tips that apply in other systems too (like SystmOne).

(If you’re looking for ways to boost your practice’s overall income from PPA, see Optimisation Strategies next.)

1. Why Accurate Coding Matters

1. No Code, No Payment

   • Simply adding a note like “B12 injection given” in a consultation won’t trigger a claim. EMIS needs a proper prescribing record flagged as “personally administered.”

2. Avoid Over- or Under-payment

   • Selecting the correct product code (drug name, brand, or specific device) ensures you get paid at the correct Drug Tariff rate.

2. Setting Up EMIS for PPA

• Use the EMIS Drug Database (dm+d Linked)

  • When you search for a drug or device in EMIS, you’re drawing from the NHS Dictionary of Medicines and Devices.

  • Look for the correct form, brand, and quantity that matches what you administered.

• Mark as “Personally Administered”

  • EMIS typically shows a checkbox or toggle when issuing a prescription to confirm it’s administered in the practice.

  • Some items may auto-flag as “PA,” but double-check—especially for less common injections.

(If you want to see exactly which items are commonly flagged, see Common PPA Items.)

3. Common Pitfalls

1. Recording Procedure, Not the Prescription

   • Nurses or clinicians might code “Influenza vaccine given” or “B12 injection given” in the consultation, but forget to generate the prescribing record.

   • Solution: Create or use a template that automatically adds the personally administered prescription entry when you code the procedure.

2. Using the Wrong Product Code

   • Example: Selecting a centrally supplied child vaccine code for an adult vaccine. NHSBSA then sees it as a “free stock” item, resulting in £0 reimbursement.

   • Solution: Always confirm brand and product name. For instance, adult flu vaccines might have multiple brand entries—make sure you choose the correct one for the age group.

3. Forgetting High-Volume Vaccine Forms

   • For certain vaccines (flu, pneumococcal, hepatitis A/B), you often use FP34D Appendix forms rather than individual claims.

   • Solution: Keep a monthly (or weekly) tally of doses administered and ensure they’re included in the appendix submission, not just a standard prescription route.

4. Running Monthly Searches to Catch Errors

• Mismatch Searches

  • Some practices use Ardens templates or create custom EMIS searches that look for clinical codes (e.g., “Depo injection given”) without a matching drug issue in the same time frame.

  • This flags patients who likely had an injection documented but not properly claimed.

• Review Claimed Items

  • You can also look at the “Medication Issued” reports in EMIS (or ePACT2 data) to ensure volumes match your internal logs.

• Backdating

  • If you find missed claims, you can often backdate them, though you want to do this ASAP—ideally within 6 months. (Some areas allow up to 6 years if you have supporting data, but the sooner the better.)

5. Tips for Smooth Workflows

1. Templates & Protocols

   • Consider building EMIS templates for frequent procedures (e.g., “Depo injection,” “B12 injection,” “Zoladex implant”) that automatically create a drug issue marked as personally administered.

   • This reduces the chance of forgetting the key step.

2. Educate All Staff

   • Nurses, healthcare assistants, GPs, and even locums should know the process.

   • A quick induction can prevent missed claims.

3. Monthly Audit

   • Have your practice manager or designated admin run a quick monthly check to catch any anomalies.

   • Compare any “Injections given” codes vs. actual prescribing data.

4. Keep Brand & Form Details Up to Date

   • When you introduce a new brand of vaccine or device, ensure it’s in EMIS with the correct dm+d code.

   • If EMIS doesn’t auto-flag it as PA, manually set that option.

Quick Example: B12 Injection Workflow

1. Nurse loads the consultation template.

2. Selects “Hydroxocobalamin 1mg/1ml solution for injection” from the EMIS drug database.

3. Clicks “Personally Administered” (or verifies it’s auto-selected).

4. Enters dose given (1 vial, IM injection).

5. Saves and closes. EMIS generates a record that the item was dispensed in-house.

6. At month’s end, it appears on the practice’s prescription claim data for NHSBSA processing.

Conclusion

Whether it’s a common injection like vitamin B12 or a seasonal vaccine drive for flu, correct coding in EMIS (or any other system) is vital to recoup your costs. With templates, monthly audits, and proper training, you’ll ensure every item you administer is claimed accurately.

Next: Optimisation Strategies: Making PPA Work for Your Practice

Looking for More?

• Still not sure if you should stock or prescribe a certain injection? Check out Deciding When to Use Practice Stock vs. FP10.

• Once you’ve nailed the coding details, see how to maximize your PPA income in Optimisation Strategies.