In our proposed rule comments, the Academy requested specific clarification regarding repackaged Avastin and if modifier -JZ is applicable. Although the responses in the 2024 Medicare Physician Fee Schedule did not specifically mention repackaged Avastin, CMS confirmed its policy allowing the administration of repackaged dosage derived from single-dose vials to multiple patients in accordance with aseptic conditions and proper pharmacy standards. When single dose syringes are administered with no discarded amounts excluding overfill, CMS advised that modifier -JZ would be appropriate since any remaining drug is not reportable with modifier -JW. We will continue to monitor any Medicare administrator contractor published policies related to Avastin for ophthalmic use and provide any updates to this guidance.

Find retina coding resources, including the Table of Common Retina Drugs at aao.org/retinapm. If you experience denials related to the modifier -JZ, send your questions to retinapm@aao.org.