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  • Introducing JZ Modifier

    In 2017 the Centers for Medicare & Medicaid Services (CMS) established a uniform policy for all Medicare administrative contractors (MACs) that required the use of JW modifier to report the discarded drugs, 1 unit or greater, from a single-use vial. 

    CMS relies on this claims data to receive refunds from manufacturers pursuant to section 90004 of the Infrastructure Act. Due to noncompliance with JW modifier use, CMS has introduced JZ modifier. The JZ modifier is appended to the Healthcare Common Procedure Coding System (HCPCS) code to identify no waste was discarded from a single-dose vial drug when -JW is not required. Both JW modifier and JZ modifier should only be used for claims that bill single-dose vial drugs. 

    JZ modifier was effective Jan. 1, 2023, and CMS recently published FAQ JW Modifier and JZ Modifier Policy. The Academy recommends not using JZ modifier until CMS and the MACs have published additional guidance. Implementation must occur by July 1. Claims filed for drugs furnished on or after July 1, that do not report the JW or JZ modifier may be subject to provider audits.  

    Claims that do not report the modifiers as appropriate on or after Oct. 1 may be returned since they will be unable to be processed. The Academy will continue to push to further delay implementation of this policy.