Billing and Filling: Glucagon Emergency Products
Glucagon emergency products are typically low audit risk – when billed correctly. Billing the wrong unit of measure, like “EA” instead of “mL”, is an easy target for auditors to flag. Below is a table to aid in billing the correct unit of measure.
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| Medication | Dosage Form | Strength | Billing Unit | FDA Approved For | Dose |
| Baqsimi® | Nasal Powder | 3 mg | EA | Age ≥ 4 | 3 mg |
| Glucagon Emergency Kit (glucagon for injection) | Vial for injection | 1 mg/ml | EA | Adults and pediatric patients weighing 20 kg or more | 1 mg |
| Pediatric patients weighing less than 20 kg | 0.5 mg | ||||
| Gvoke HypoPen® (glucagon injection) | Auto-injector | 0.5 mg/0.1 mL 1 mg/0.1 mL 1 mg/0.2 ml | mL | Age 2-11 and < 45 kg | 0.5 mg |
| Gvoke® PFS (glucagon injection) | Pre-filled syringe | 0.5 mg/0.1 mL 1 mg/0.2 mL | Age ≥ 12 or > 45 kg | 1 mg | |
| Gvoke Kit (glucagon injection) | Vial for injection | 1 mg/0.2 ml | mL | Age 2-11 and < 45 kg | 0.5 mg |
| Age ≥ 12 or > 45 kg | 1 mg | ||||
| Zegalogue® (dasiglucagon injection) | Auto-injector Pre-filled syringe | 0.6 mg/0.6 mL | mL | Age ≥ 6 | 0.6 mg |
PAAS Tips:
- Typically, billing one product for a 1-day supply is appropriate
- Ensure staff are aware of which products are billed as “EA” vs. “mL”
- Note the different age groups that each product is FDA approved for and the correct corresponding dose
- If multiple kits are being prescribed and dispensed, document the need (e.g., one for home and one for school or daycare)
- Note the frequency of refills and use caution with excessive refills – balance patient care and clinical intervention with waste
- Always clarify with the prescriber if the unit of measure is incorrect or listed as “unspecified” and document a clinical note accordingly
- A complete clinical note should include:
- Date and time
- Name and title of individual providing information
- Specific information clarified
- Pharmacy staff initials
Analyst at PAAS National®
Fresh out of high school, I had no idea what I wanted to do for my career. I took a job at Walgreens in the photo department in 2015. About a year into working in the photo department I was asked to help the pharmacy, and I immediately fell in love with how fulfilling being a pharmacy technician felt. I moved fully into the pharmacy, got my national certification, and worked my way up to becoming Senior Technician! In 2020, I accepted a job offer with a Kroger pharmacy location and worked there for two years. I attended vaccine clinics and got to see sides of the pharmacy I had never seen before. I was then offered a change in direction in 2022. I was lucky enough to work for a remote pharmacy company that helped independent pharmacies run a med sync service, as well as sending out safety alerts to providers in hopes of preventing accidental opioid overdosing and interactions. The connections I made at my previous jobs have brought me here, to PAAS! I am over the moon with excitement and look forward to helping your pharmacy!
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