Wiki gentamicin 120 mg vs 80 mg J1580

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tgenia

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Hi all,
I am trying to charge out gentamicin 120 mg. The hcpcs J1580 only allows 80 mg. If I use two units it equals 160 mg, then I am wasting 40 mg. Can anyone shed a light on how they have handled this, this patient is not a mcare insurance payor.
Thanks in advance
 
You still would have to bill out the 120mg (so 2 units) and have the provider document that they are wasting 40 mgs. We use this for our prostate biopsies and I have yet to have any payer deny this.
Per MCR, "The Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual, Publication 100-04, Medicare Claims Processing Manual, Chapter 17, Section 40, states: 'When a physician, provider, hospital or supplier must discard the remainder of a single use vial or other single use package after administering a dose/quantity of the drug or biological to a Medicare patient, the program provides payment for the amount of drug or biological administered as well as any amount that is discarded up to the maximum amount of the drug or biological as indicated on the vial or package label.'
A JW modifier is not required.
Hope this helps!
 
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