Wiki Medication Billing: Misoprostol

[ppaule]

Hello, our patient took Misoprostol but had to spit right away due to anterior placenta. Is this considered administered and billed as is? Or do we bill the medication as discarded drug with modifier -JW?

Thanks for all your help

 

[CBLENNIE]

I believe you would bill this as an administered medication because the patient did put the medication in their mouth but then spit it out. I work for an insurance company, and we would not consider it appropriate to bill this as discarded/wasted medication billable with modifier JW because the patient did attempt to take the medication in this instance.

We consider medications as discarded or wasted when there is no attempt to administer the medication. We will cover the wastage as long as the medication only comes in a single use vial/package and the smallest vial/package size is used.