Since January 1, 2017, when a provider or supplier discards the amount of a Part B drug or biological (drug) that was unused from a single-dose container or a single-use package after administering a dose to a Medicare patient, Part B provides payment for the discarded amount, as well as the dose administered, up to the amount of the drug shown on the vial or package labeling. CMS requires uniform use of the JW modifier (Drug amount discarded/not administered to any patient) when processing Part B claims for drugs and biologicals from single-use vials or single-use packages. Providers must document the amount of discarded drugs in the medical records of Medicare patients.
Effective July 1, 2023, providers must report the JZ modifier on all claims that bill for drugs separately payable under Part B when there’s no discarded amount from single-dose containers or single use packages. For the amount the provider administers, the claim line should include the billing and payment code, such as a HCPCS code, describing the given drug, the JZ modifier showing there were no discarded amounts, and the number of units administered in the units’ field.
Michele Krpata, BSW, CPC, CPMA
Compliance Officer, Quality Reporting Analyst