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intraperitoneal infusion smalfunction

Linda Posted Thu 05th of December, 2013 14:39:03 PM

If a patient has an intraperitoneal saline drip started and carbo was to be put into the drip but the port was nonfunctioning, can we bill for the carbo? the carbo was pulled from the pharmacy and ready to be administered. The port malfunction was noticed while the saline was being administered before the carbo was started. I'm thinking we can charge for saline and admin for saline only with no carbo charges.

SuperCoder Answered Thu 05th of December, 2013 20:47:17 PM

We are working on this.


SuperCoder Answered Thu 05th of December, 2013 20:47:17 PM
With Editor
SuperCoder Answered Thu 05th of December, 2013 22:02:42 PM

The Medicare Claims Processing Manual, chap. 17, section 40, on billing wasted drugs specifically refers to coding for drugs not administered AFTER administering some to the patient: "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."

This BSBCNC policy states, "A provider cannot bill BCBSNC for discarded drugs if none of the drug was initially administered to a patient (e.g. BCBSNC beneficiary misses an appointment)."

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