Wiki MUE and drug waste

[tralbrecht]

I have drugs denying for exceeding the CMS MUEs. In certain instances, we are administering single dose vials. The waste exceeds the MUE. According to CMS, we are allowed to be reimbursed for waste. My question is, does the MUE include the waste, or can we exceed the MUE with waste, as long as the amount ACTUALLY administered is at or less than the MUE?

 

[rachaelwilleford]

MUE includes all units billed. When the "powers that be" evaluate codes for MUE, they typically take into account the usual and customary use of whatever is being billed. I've seen some of the drug MUEs, and usually they're pretty high or at what is considered FDA approved. I would double check the amount documented and the amount being billed (particularly the units). If this is a continuing issue, pharmacy or whoever is sourcing the drug may need to purchase smaller vials to reduce the waste, if possible.