Wiki Waste of drug quantity is more than the drug dispensed quantity

[sam.anderson@curemd.com]

We have a case where drug J9035 was billed with NDC measuring Unit ME and NDC quantity for dispensed drug is 200 mg and the waste quantity is 800mg. Please guide, in such case where waste quantity is more than the dispensed quantity, would we bill the waste in this case or would we bill the dispensed and waste quantities both.

First line J9035 NDC measuring unit ME and NDC Quantity 200mg
2nd line J9235 NDC measuring unit ME and NDC Quantity 800mg Modifier JW.

Please guide how I will proceed in this case with waste and dispensed quantity.

 

[sls314]

We have a case where drug J9035 was billed with NDC measuring Unit ME and NDC quantity for dispensed drug is 200 mg and the waste quantity is 800mg. Please guide, in such case where waste quantity is more than the dispensed quantity, would we bill the waste in this case or would we bill the dispensed and waste quantities both.

First line J9035 NDC measuring unit ME and NDC Quantity 200mg
2nd line J9235 NDC measuring unit ME and NDC Quantity 800mg Modifier JW.

Please guide how I will proceed in this case with waste and dispensed quantity.

Can you clarify why there is 800 mg waste for 200 mg dispensed?

As far as I'm aware, Avastin (bevacizumab) comes in 2 vial sizes 100 mg/4 mL and 400 mg/16 mL. Even if the 400 mg vial had to be used, that would still be only 200 mg wasted.

I just wanted to be sure that the waste of 800 mg is accurate.

 

[sam.anderson@curemd.com]

Actually when the drug was started giving to the patient the patient fainted and the drug administration stopped and wasted. This is the reason the drug had to be wasted more than the dispensed quantity.

 

[Alicia D G]

It would be appropriate to bill the drug administered and drug waste as indicated above; ensure that you report the correct admin code for infusion time/type. Documentation in the EMR should indicate the waste, administration and infusion details to support the charge in audit. This is subject to payer rules and policies.

 

[trarut]

Agree this is billable but it will likely raise some flags. I would go one step further and make sure the waste is appropriately documented in your medical record before submitting the claim - and the drug reaction if it isn't already. Our system reports "dispensed" waste charted by Pharmacy separately from "discard" drug that is charted by the nurse if an infusion has to be stopped and can't be continued. It's a good bet you will need to send records for a denial or, if they pay, that you'll get audited on waste later and have to prove the reason for the large quantity. Best to make sure now that your records are complete.