Wiki Minimum wasted drug (JW)

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tjones05

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I am trying to find what the regulations are for wasted drugs for infusions. For example J1602 Simponi Aria is 50mg for 1 vial. We use 4 vials but have to waste part of it due to patients weight.
I tried looking on CMS for what is the minimum amount of a vial before it is not going to paid.

Any help would be appreicated.
Thanks
 
In general carriers will pay for drug waste for single use vials when the most appropriate size vial, or combination of vials, to deliver the administered dose is billed. This may mean more than one vial size is utilized to ensure that the least amount of the drug is wasted.
 
Ok take the NDC over the a NDC website like DailyMed, look under the drug, and see if it says "single vial drug". If there is MORE than one amount/type listed, you want to make sure you are using the correct size vial is used for your mg/ml, so the least amount is wasted.
 
I would suggest you use the FDA's NDC lookup site linked here NDC look up tool. The benefit of using it is that it will not only tell you if a specific NDC is a single use vial, if you search by drug name it will show you the NDCs for various vial sizes so you can ensure you are purchasing the vials sizes that are most appropriate for your practice's general treatment protocols for a given drug. Here is an example of what you would see for Veklury which is packaged in single use vials.

1697121150411.png

Another benefit to using the FDA's NDC lookup site is that it is the official source for the information on drugs. I'm not trying to dismiss @Tourist95's recommended website; however, as someone who has worked in Payment Integrity auditing drug waste claims for an insurance company, I can tell you that we go to the official regulatory source of information regarding drugs, i.e. the FDA.

Another benefit of using this website is that you can click on the drug name in the first column it will link you to the packaging insert for the drug, which will typically tell you how the drug is packaged.
1697121837334.png
 
CBLENNIE said:
I would suggest you use the FDA's NDC lookup site linked here NDC look up tool. The benefit of using it is that it will not only tell you if a specific NDC is a single use vial, if you search by drug name it will show you the NDCs for various vial sizes so you can ensure you are purchasing the vials sizes that are most appropriate for your practice's general treatment protocols for a given drug. Here is an example of what you would see for Veklury which is packaged in single use vials.

View attachment 6487

Another benefit to using the FDA's NDC lookup site is that it is the official source for the information on drugs. I'm not trying to dismiss @Tourist95's recommended website; however, as someone who has worked in Payment Integrity auditing drug waste claims for an insurance company, I can tell you that we go to the official regulatory source of information regarding drugs, i.e. the FDA.

Another benefit of using this website is that you can click on the drug name in the first column it will link you to the packaging insert for the drug, which will typically tell you how the drug is packaged.
View attachment 6488
Click to expand...

I also work in Payment Integrity in FWAE.. I am an auditor at Optum, and our official guidance is using Daily Med. Thanks though!
 
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