tci Part B Insider - 2012 Issue 9

Reader Question: Not All Drug Wastage Is Billable

Question: How should I bill for wasted drug? Our physician often splits a single vial between two patients, but there is still some leftover. For example, he administers Botox (botulinum type A) using the 100-unit size vial. He splits the injection between two separate patients, administering 40 units to each patient. How do we report this, and can we get reimbursed for the entire amount?Answer: For the Botox example you give, you should bill as follows:Patient 1: J0585 (Injection, onabotulinumtoxin A, 1 unit), 40 unitsPatient 2: J0585, 60 units, as long as the chart includes documentation of the...

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