CMS Now Requires JW Modifier for Discarded Drug

The Centers for Medicare & Medicaid Services (CMS) releasedĀ Transmittal 3508 that now requires the use of the JW modifier to report discarded drugs and biologicals from single use vials or single use packages. Previously, CMS Medicare Administrative Contractors (MACs) had the discretion to require the JW modifier on claims with discarded drugs. CMS will now uniformly require the use of the modifier on all claims with Part B discarded drugs and biologicals. CMS states that the policy change was made “to more effectively identify and monitor billing and payment for discarded drugs and biologicals.”

This change is effective July 1, 2016. It is important to note that Transmittal’s related MLN Matters article MM9603, specifically states that the discarded drug or biological must be documented “in the patient’s medical record when submitting claims with unused Part B drugs or biologicals from single use vials or single use packages that are appropriately discarded.” Please work with your staff to educate them about this policy change and the required documentation that must appear in the patient’s medical record. Again, this change is effective July 1, 2016.

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