Oncology & Hematology Coding Alert

Question: Whats the best way to code for chemotherapy drugs when one vial is used for several patients? For example, if you had a 100-unit vial and three patients each got 30 units, who pays for the other 10 units?

Anonymous MI Subscriber

Answer: If its a multi-dose vial, you could use the additional 10 units for another patient, assuming the drug was not past the expiration date. You bill the exact units per patient that you used. In a case where you would not be able to use the remaining drug on another patient and you would not have another patient scheduled to use that drug within the next few days, you would bill the patient the total dose of the vial and document in the chart the waste amount. You would document in the flow sheet what dose the patient actually received, and the administration, and in the progress note sheet you document the total dose that was wasted. Its very simple. What you waste, you have to document. You would be reimbursed for the total contents of the vial, both what was used and what was wasted, as long as it was documented.