Implementation of dispense waste functionality with new electronic health record system

Area of Science:

• Pharmacy Practice
• Healthcare Administration
• Regulatory Compliance

Background:

• The JW modifier facilitates billing for discarded drugs, while the JZ modifier indicates no discard from single-dose containers.
• Accurate modifier use is crucial for resource stewardship, particularly in pediatric settings with patient-specific dosing.
• The Centers for Medicare & Medicaid Services mandated JZ modifier reporting for single-dose container drugs starting July 1, 2023.

Purpose of the Study:

• To implement and adjust practices for regulatory compliance with JZ modifier documentation.
• To improve the accuracy of reporting discarded drugs from single-dose containers.

Main Methods:

• A soft go-live in June 2023 allowed for process adjustments.
• Initial waste documentation during preparation was 31.1%.
• A pharmacy technician was trained for retrospective waste documentation, followed by monthly monitoring and staff education. Real-time documentation during compounding increased to 85.9% by February 2024.

Main Results:

• Real-time waste documentation during drug preparation increased significantly.
• Compliance rose from 31.1% to 85.9% within eight months (P < 0.001).
• Process improvements reduced the need for retrospective waste reporting and associated resource utilization.

Conclusions:

• Process implementation and staff education were key to improving compliance.
• The study demonstrates a successful transition to accurate JZ modifier documentation.
• Enhanced real-time waste documentation optimizes resource management and billing accuracy.