Awareness : OBC Tips

JW Modifier

JW Modifier should be appended to Medicare Part B claims for discarded drugs/biologicals obtained from single-dose vials or other single-use packings.

On Medicare Part B claims, the JW modifier should be appended for discarded drugs/biologicals obtained from single-dose vials or other single-use packagings.  Providers are encouraged to follow these instructions to avoid drug/biological wastage.  Providers must use the smallest package size available from the manufacturer or the package size that is the closest to the patient’s prescribed dosage amount. Documentation of both the administered
portion and the discarded portion of the drug/biological must be included in the patient’s record. When billing for the discarded drug/biological, a line item for the discarded amount with the –JW modifier appended in addition to a line item for the administered amount (with no –JW modifier) is required unless, together, these amounts are less than the HCPCS dosage definition assigned to that drug/biological. Use of the –JW modifier does not apply to drugs/biologicals that are: (1) drawn from multi-dose vials, (2) submitted on inpatient claims, or (3) not separately payable (such as those assigned to Outpatient Prospective Payment System status indicator N).

Source: HCCA Compliance Today January 2018