Gastroenterology Coding Alert

Question: We perform Remicade infusions in our office. We typically report J1745 (for the medication) along with other procedure codes. A patient was supposed to receive three vials of medication but received only one when the physician decided she could not complete the infusion because of an unexpected problem that threatened the patient's safety. Two vials were left unused. How should I report the situation? How about appending modifier JW to describe waste in medication?

Answer: First, if the total infusion time was less than one hour you should report the infusion service with code 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug).

To report for a portion of a vial of injected medication that must be discarded as waste, you should add modifier JW to the HCPCS medication code. Remember to indicate the number of units discarded and the calculated submitted price for the amount of drug discarded.