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Our MAC does not currently require the assignment of the JW modifier to identify unused drugs and biologicals from single use vials or packages that are properly discarded.  In our Cancer Center and observation outpatients, frequently we are charging an entire single dose vial to the patient when only a portion of the single dose vial was administered to the patient according to treatment parameters.  The amount of drug discarded is not documented in the medical record.  We would like to implement nursing and/or pharmacy documentation to support the amount of discarded drug since it is not being used for another patient.  What are you doing in your institutions?