decisionhealth Newsletters, Coder Pink Sheets - 2023 Issue 3 (March)
CMS publishes FAQ on modifiers JW and JZ
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Article Overview
This article explains that CMS has released an FAQ addressing the Medicare discarded-drug modifier policy for HCPCS claims. It is relevant to orthopedic and other practices billing Medicare Part B for separately payable drugs supplied in single-dose or single-use formats, and it highlights the timing of policy implementation, CMS clarification points, and the broader compliance context. The piece is useful for coding, billing, and revenue cycle staff who need to understand the scope of the CMS guidance and the general areas covered in the FAQ.
Why This Topic Matters
Providers billing drugs under Medicare Part B need to be aware of CMS guidance that affects claim processing, compliance monitoring, and audit risk. The article helps practices identify that a new FAQ has been issued and that reporting expectations are tied to specific HCPCS modifier usage and effective dates.
What You Will Learn
- What CMS’s FAQ addresses about the discarded-drug modifier policy
- Which billing contexts are affected by the guidance
- How the policy’s timing and compliance emphasis may affect Medicare claims workflows
- What broader legislative and regulatory background CMS cites for the policy
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle managers
- Orthopedic practice administrators
- Compliance staff
Modifiers Discussed
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