Loading...

JW Modifier: Drug Amount Discarded/Not Administered to any Patient

Published: August 9, 2016 by Experian Health

Effective January 1, 2017, when processing claims for Part B drugs and biologicals, except those provided under Competitive Acquisition Program (CAP), the use of the JW modifier to identify unused drugs or biologicals that are appropriately discarded is required. 

The current policy allows contractors the discretion to determine whether to require the JW modifier for any claims with discarded drugs or biologicals, and the specific details regarding how the discarded drug or biological information should be documented.

In order to more effectively identify and monitor billing and payment for discarded drugs and biologicals, CMS is revising this policy to require the uniform use of the JW modifier for all claims with discarded Part B drugs and biologicals.

Also, effective January 1, 2017, providers are required to document the discarded drug or biological in the patient’s medical record.

CMS encourages physicians, hospitals and other providers and suppliers to care for and administer drugs and biologicals to patients in such a way that they can use drugs or biologicals most efficiently, in a clinically appropriate manner.

Read the entire MedLearn Matter Article 9963 here: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9603.pdf

Related Posts

With the Appropriate Use Criteria program slated to go into effect in 2023, healthcare providers shoud implement new alerts for prior authorizations.

Published: October 24, 2022 by Experian Health

Healthcare data breaches are nothing new, but their size and frequency are increasing: CVS Health lost over a billion...

Published: June 25, 2021 by Experian Health

The pandemic dominated healthcare in 2020, but it won’t be recognized as a reason to delay complying with CMS’...

Published: June 7, 2021 by Experian Health

Subscribe to our blog

Enter your name and email for the latest updates.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Subscribe to the Experian Health blog

Get the latest industry news and updates!
Subscribe