by Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Nov 28th, 2016 - Reviewed/Updated Aug 1st
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.
About Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Christine Woolstenhulme, CPC, QCC, CMCS, CMRS, is a Certified coder and Medical Biller currently employed with Find-A-Code. Bringing over 30 years of insight, business knowledge, and innovation to the healthcare industry. Establishing a successful Medical Billing Company from 1994 to 2015, during this time, Christine has had the opportunity to learn all aspects of revenue cycle management while working with independent practitioners and in clinic settings. Christine was a VAR for AltaPoint EHR software sales, along with management positions and medical practice consulting. Understanding the complete patient engagement cycle and developing efficient processes to coordinate teams ensuring best practice standards in healthcare. Working with payers on coding and interpreting ACA policies according to state benchmarks and insurance filings and implementing company procedures and policies to coordinate teams and payer benefits.