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CC .vs. UNITS

Nicole Posted Wed 04th of September, 2013 13:38:18 PM

I have a patient that was given .7cc of Vitrase. The code(s) I believe that should be used are either J3471 or J3472. I am just not sure how to convert this because the measurement on these codes are 'J3471- per 1 USP unit (up to 999 USP units)' and 'J3472- per 1,000 USP units'.
What is the proper conversion of drugs being administered for CC to USP units?

Any help would be greatly appreciated.

SuperCoder Answered Thu 05th of September, 2013 13:09:06 PM

Please bear with us...we are researching on this query.

SuperCoder Answered Thu 05th of September, 2013 13:09:06 PM
Need somebody confident with answering this.
SuperCoder Answered Mon 09th of September, 2013 19:24:54 PM

Assuming (be sure to check the record!) a 200 USP Units/mL single use vial was used, you should be able to report a total of 200 units of J3471. Check the local payer’s rules regarding reporting waste in single-use vials. Requirements can vary.

Here is some information to consider for your final decision …

The FDA page at http://www.drugs.com/pro/vitrase.html includes a table showing that .75 mL withdrawn from the vial is about 150 units.

Vitrase is available in 200 USP Units/mL vials in sterile solution (http://www.bausch.com/en/ECP/Our-Products/Rx-Pharmaceuticals/Rx-Pharmaceuticals-ECP/Vitrase). And the full prescribing information (click at bottom of Bausch page) states, “Ovine hyaluronidase 200 USP Units/mL single use vials.”

Medicare Claims Processing Manual, Chapter 17, Section 40, states:
“When a physician, hospital or other provider or supplier must discard the remainder of a single use vial or other single use package after administering a dose/quantity of the drug or biological to a Medicare patient, the program provides payment for the amount of drug or biological discarded as well as the dose administered, up to the amount of the drug or biological as indicated on the vial or package label.” http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c17.pdf
Assuming (be sure to check the record!) a 200 USP Units/mL single use vial was used, you should be able to report a total of 200 units of J3471. Check the local payer’s rules regarding reporting waste in single-use vials. Requirements can vary.

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