Medicare says carriers can require JW modifier to show wastage

Why This Topic Matters

The guidance affects how providers report wasted medication and how claims may be reviewed by Medicare contractors. Understanding the article helps billing and compliance teams stay aligned with carrier requirements and Medicare drug-reporting practices.

Article Sections

1. CMS transmittal and modifier JW guidance

   Overview of the Medicare change described in the transmittal and the circumstances in which carriers may request additional reporting for unused portions of drugs or biologicals.

2. CMS examples involving Botulinum Toxin Type A

   Illustrative scenarios from CMS showing how discarded amounts may be associated with claims in common multi-patient and single-patient scheduling situations.

3. Broader application to other drugs and biologicals

   Discussion of how the guidance extends beyond a single product and may apply more broadly to Medicare Part B drugs and biologicals.