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  • Introducing Modifier -JZ

    In 2017 the Centers for Medicare & Medicaid Services (CMS) established a uniform policy for all Medicare administrative contractors (MACs) that required the use of modifier -JW 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 modifier -JW use, CMS has introduced modifier -JZ. 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 modifier -JW and modifier -JZ should only be used for claims that bill single-dose vial drugs. 

    Modifier -JZ was effective Jan. 1, 2023, and CMS recently published FAQ JW Modifier and JZ Modifier Policy. The Academy recommends not using modifier -JZ 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.