Pharmacy Question for the Week of April 3, 2017

Question:

I thought it was Medicare payers that decided whether modifier JW was required on claims but ours says it is not responsible for this decision. Can you provide information on this?

Answer:

Effective January 1, 2017, contractors no longer have discretion to determine whether the JW modifier is required for Part B claims. According to policy from the Centers for Medicare & Medicaid Services (CMS), providers and suppliers are required to report the JW modifier for discarded drugs and biologicals billed on outpatient claims. Providers and suppliers must comply with medical record documentation requirements for recording the amount of discarded and dose administered.

Facebook
Twitter
LinkedIn
Email
Print

CPT® copyright 2022 American Medical Association (AMA). All rights reserved.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.