by Christine Woolstenhulme, CPC, CMRS, QCC, QMCS
November 28th, 2016
When using the JW modifier for Part B drug claims for discarded drugs and biologicals, any amount of wasted material should be clearly documented in the medical record with the following information:
- Date, time, and location of treatment
- Approximate amount of product unit used
- Approximate amount of product unit discarded
- Reason for the wastage
- Manufacturer’s serial/lot/batch or other unit identification number
Medicare contractors may also require providers to report discarded amounts of products such as skin substitutes on a separate claim line item by attaching the JW modifier. If reporting skin grafts or substitutes, be sure to report the manufacturer’s serial/lot/batch or other unit identification number of graft material.
Reminder: The JW modifier is required for use on all claims with discarded Part B drugs and biologicals as of January 1st, 2017. Also, effective January 1st, 2017, providers must document the discarded drugs or biologicals in the patient's medical record.
It is also important to note the following:
- The JW modifier is not used on claims for CAP drugs and biologicals.
- Multi-use vials are not subject to payment for discarded amounts of drug or biological.
- The JW modifier is only applied to the amount of drug or biological that is discarded.
- The Modifier is billed on a separate line.