CMS Posts Drug Codes That May Start ‘Rejecting’ Without JZ, JW Modifier

CMS has released a list of HCPCS codes that require either a JZ or JW modifier on Medicare claim forms, depending on the setting, and has updated its FAQs on the modifiers.[1]

Hospitals and other providers and suppliers on July 1 were required to start reporting one of two modifiers when they discard separately payable drugs or biologicals: either the new JZ modifier when they don’t waste drugs or biologicals from a single-use vial, or the longstanding JW modifier when they waste drugs from a single-use vial, which generates reimbursement. Effective Oct. 1, claims without one of the modifiers may be returned as “unprocessable until claims are properly resubmitted,” and providers may face audits, CMS said in the FAQs.[2]

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