Question:

I have a question regarding billing for Kinevac (J2805—injection, sincalide, 5 mcg). This is a weight-based drug so, if based on the patient’s weight, we need to give 1.6 mcg, do we round up and charge 2 mcg?

Answer:

With a billing dose unit of 5 mcg, you would bill x 1 because the 1.6 mcg given is less than the billing dose of 5 mcg. You only bill x 2 if you give more than 5 mcg. You would round up when you give more than the billing dose, not when you give less. For example:

  • 5 mcg or less = x 1
  • 5.1 mcg – 10 mcg = x 2
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