Oncology & Hematology Coding Alert

Question: If we have to waste part of a single-use drug vial, how should I calculate the units I report to Medicare for the drug?


Michigan Subscriber


Answer: The bottom line is that the total units you report should at most add up to the amount indicated on the vial or package.

Example: Your vial says it contains 100 units, but it actually contains 101 units. You use 75 and must waste the rest.

If your payer asks you to report the total on one line, report 100 units total. If your payer asks you to report the amount used and the amount wasted on separate lines, report 75 used and 25 wasted.

Reason: Medicare Claims Processing Manual Transmittal 1248 explains that Medicare covers the discarded drug or biological amount along with the administered amount -up to the amount of the drug or biological as indicated on the vial or package label- (www.cms.hhs.gov/transmittals/downloads/R1248CP.pdf). As Transmittal 1248 discusses, your payer may require you to append modifier JW (Drug amount discarded/not administered to any patient). Ask your payer to be sure.

Don't forget: Medicare won't pay for wasted amounts from multi-use vials and encourages you to schedule multiple patients requiring the single-use vial drug on the same day (when clinically appropriate) to avoid drug waste.

The answers for You Be the Coder and Reader Questions were reviewed by Cindy C. Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Powder Springs, Ga., and past-president of the American Academy of Professional Coders National Advisory Board.