“Finally Friday!” Review of CMS’ JW Modifier and SAD Billing Policies

FRIDAY May 27, 2016:

All Things Pharmaceutical

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The combination of drugs and EMRs is may drive you to drink take drugs look for new work.

The combination of drug administration & billing and your EMR may drive you to drink take drugs look for new work.

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Sponsored by The Health Law Partners, MAS Coding Solutions


THIS WEEK, by popular request, we (mostly Bill Malm) went over two difficult issues related to pharmaceuticals in the hospital. First, there was a recent change made via Transmittal 3508, dated April 29, 2016, to take effect on July 1, 2016. The Transmittal requires the use of modifier JW to report drug wastage. Many questions have arisen about who can possibly know what, when would they know it, how do they put it into the record with the EMR, what should they put in, and we haven’t even mentioned the billing questions yet.

And then there was Part 2, on Self-Administered Drugs (SAD).

Read Transmittal , then focus on this image. Still fuzzy? Then you need to watch our show.

Read Transmittal 3508, then focus on this image. Still fuzzy? Then you need to watch our show.

Get our FAQs document here.

We covered in the videos:

  • How can you (or even should you) use the most efficient package size available from a pharma vendor?
  • Can you do that all the time, and if you can’t, what to do instead?
  • Who specifically knows about those package sizes and how can floor staff get such knowledge?
  • How does any of this get documented in the medical record (in your EMR)? (Or is it even possible?)
  • Have you ever, do you now, or will you ever, use the JW modifier?
  • When reporting JW modifier, which revenue code should you use?
  • When is the JW modifier really required? (Or not?)

And then there’s the SAD stuff… <sigh> but that’s enough for now…

BTW, we recommend you keep a bottle of Tylenol handy.

So join us, share your own insights and bring your questions for us!

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Handouts for This Week's Show




CMS Transmittal R3508CP 55.61 KB 165 downloads


Videos of May 20 Show

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