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Billing for wasted medication

  1. #1
    Default Billing for wasted medication
    Medical Coding Books
    We have a patient that presented to our physician office for his scheduled Remicade 300 mg(J1745) infusion. One nurse mixed the medication while another nurse took the patient's vitals. It was noted that the patient didn't feel well and had a fever. The decision was made to not administer the infusion and because it was mixed we had to discard the medication. The patient has Blue Cross Blue Shield of Minnesota. I am unable to find a drug wastage policy from BCBSMN. Does anyone have any thoughts on whether this would be billable to insurance or if this is just our loss?

    Thank you in advance for your help.

  2. #2
    Nashville AAPC Chapter
    If it wasn't given to the patient you cannot bill the carrier for the drug as that isn't what "drug waste" means.

    Contact the drug company and they typically will replace the drug that was not used as no charge.

  3. #3
    You can only charge for what has been done, no infusion, no charge.

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