Drug amount discarded/not administered to any patient

Instructions

Effective January 1, 2017, providers are required to:

• Use for claims with unused drugs or biologicals from single use vials or single use packages that are appropriately discarded
• Document discarded drug or biological in patient's medical record when submitting claims with unused Part B drugs or biologicals from single use vials or single use packages that are appropriately discarded

Incorrect Use

• For those using the Competitive Acquisition Program (CAP), this does not apply as it relates to drugs and pharmaceuticals.

Claim Coding Example

Patient required 350 mg. dose Infliximab. Purchased 4 (100 mg. single dose vials) = 400 mg.
Priced at 10 mg. each

Resource

• CMS Medicare Learning Network (MLN) Matters (MM) 9603