brand logo

Fam Pract Manag. 2012;19(5):32

Use discretion with drug expiration dates

Many patients think that medications, much like milk, expire on their “expiration date.” But for many medications, these dates are marketing based more than evidence based. Most medications remain effective beyond their expiration dates – for an additional 33 months on average – according to extensive studies conducted in the 1990s by the military in partnership with the U.S. Food and Drug Administration (FDA). The military is allowed to use expired medications under the Shelf Life Extension Program, although the FDA recommends that consumers throw away expired medications. Refrigeration extends shelf life for most medications. Some exceptions are insulin, liquid antibiotics, mefloquine, and nitroglycerin, which may degrade shortly after their expiration dates. A 2000 Wall Street Journal report on this issue can be found online. Understanding that the shelf life of certain medications extends beyond their expiration dates has saved the military millions of dollars, and it could save you and your patients a few dollars as well. I don't recommend keeping medicines for decades, of course, but there's no need to throw out a bottle of aspirin that “expired” a few months ago.

Review E/M coding patterns

A recent report from the U.S. Department of Health & Human Services Office of the Inspector General (OIG) found that clinicians are billing higher levels of evaluation and management (E/M) services than they were 10 years ago and recommended that the Centers for Medicare & Medicaid Services (CMS) step up its E/M oversight.

The increase isn't all that surprising when you consider the increases in coding education, use of templates and electronic coding tools, and prevalence of chronic diseases. But practices should take steps to ensure appropriate coding. Use your computer system to identify the E/M codes that each physician in your group reported during a specified period, including the number of times they reported each one. Record the data in a spreadsheet. Then, simply compare your physicians' patterns with one another and with the CMS norms. (Download a spreadsheet that contains updated CMS data.) Any pattern that shows the majority of visits at the highest two levels in any category deserves careful scrutiny.

Based on what you find, decide whether your compliance activities need to focus on E/M servicesor another area on the OIG work plan.

Who gets to keep the EHR incentive checks?


Practice Pearls presents readers' advice on practice operations and patient care, along with tips drawn from the literature. Submit a pearl (250 words or less) to FPM at

Continue Reading

More in FPM

Copyright © 2012 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.