shanamarie
Guru
Has anyone seen this new UHC policy? I thought single use vials could only be used for 1 patient, and then we were required to discard/waste the remainder of the drug? The new policy is stating to schedule and administer single use vials to multiple patients when you can for Botox.
"The physician schedules three United Healthcare Medicare Advantage patients to receive Botox on the same day and administers thirty (30) units to each patient. The remaining ten (10) units are billed to United Healthcare Medicare Advantage on the account of the last patient. Therefore, thirty (30) units are billed on behalf of the first two patients. Forty (40) units are billed on behalf of the last patient seen because the physician had to discard ten (10) units at that point due to the limited shelf life of the drug. The first two patients are billed with J0585, thirty (30) units each. The third patient is billed as J0585, forty (40) units on one line. In the record, the documentation for the last patient should indicate thirty (30) units administered to the patient and ten (10) units wasted. If the ten (10) units wasted are not indicated in the medical record, the physician will only be reimbursed for the thirty (30) units administered to the patient."
"The physician schedules three United Healthcare Medicare Advantage patients to receive Botox on the same day and administers thirty (30) units to each patient. The remaining ten (10) units are billed to United Healthcare Medicare Advantage on the account of the last patient. Therefore, thirty (30) units are billed on behalf of the first two patients. Forty (40) units are billed on behalf of the last patient seen because the physician had to discard ten (10) units at that point due to the limited shelf life of the drug. The first two patients are billed with J0585, thirty (30) units each. The third patient is billed as J0585, forty (40) units on one line. In the record, the documentation for the last patient should indicate thirty (30) units administered to the patient and ten (10) units wasted. If the ten (10) units wasted are not indicated in the medical record, the physician will only be reimbursed for the thirty (30) units administered to the patient."