tci Part B Insider - 2013 Issue 5

Compliance: OIG Slams Practices for Billing Full Vials of Multi-Use Drugs

Warning: Modifier JW does not apply to multi-use vials. Waste not, want not. That’s the word from the OIG, which advised medical practices that those who waste precious units of multi-vial drugs must not want to keep their Medicare reimbursement checks. The OIG’s report, which the agency issued on Feb. 5, revealed that when the OIG audited claims for full vials of Herceptin—a breast cancer drug—it found that 80 percent were billed incorrectly, totaling more than $1 million in overpayments to medical practices.  “For multiuse vials, Medicare pays only for the amount administered...

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