Multi use vial*****HELP


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We have a medication that comes in a multi use vial, because of stock reasons we had to order two 20mg vials. We gave that patient 29 mg, code requires per 5 mg. Since we can't do a discard of the medication how would you suggest I bill this out? Would we round up to 30mg?

Any help or suggestions would be greatly appreciated.

Multi-use vials

According to the Medicare Claims Processing Manual, Chapter 17, Section 40 (
“Multi-use vials are not subject to payment for discarded amounts of drug or biological.”

Also in Section 10 of the same chapter:
“If the drug dose used in the care of a patient is not a multiple of the HCPCS code dosage descriptor, the provider rounds to the next highest unit based on the HCPCS long descriptor for the code in order to report the dose provided.”

Therefore, if the corresponding code only comes in 5 mg increments, it would be best to bill 6 units of that code.