Compounded Products (Phenylephrine Syringes) for Ambulatory Settings - Billing and Compliance Crosscheck

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Mon, 09/26/2022 - 13:08
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Brent Dammeier
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Compounded Products (Phenylephrine Syringes) for Ambulatory Settings - Billing and Compliance Crosscheck

Hi all,

We recently implemented the use of 503(b) compounded phenylephrine syringes for increased safety in our perioperative settings but are encountering concerns from our Billing team.

They are referencing that CDC and CMS guidelines for SDV's specifically say you cannot share Single Dose Vials (SDV) with multiple patients and because these vials were made from SDV at the compounder we may not be reimbursed for them when used in the Periop/ED settings. Also, that their use could even jeopardize the reimbursement of an entire OR case.

They are still evaluating billing codes and other pieces that go a little over my head right now, so I am seeking any advice or learnings if other have been challenged by having safety initiatives/specific products run against billing and potential compliance issues.

We are encountering this similar issue with a cost saving initiative with compounded Cathflo syringes and are being told we need to avoid using them in the Ambulatory setting (including Periop/ED).

I would greatly appreciate any perspective.
Thank you!
Brent Dammeier

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