Reminder-Billing and Coding JW and JZ Modifiers
Policy Update #: POLJWJZMOD010117
Effective Date: January 1, 2017 (JW Modifier) July 1, 2023 (JZ Modifier)
Current State:
Sentara Health Plans complies with CMS requirements for the use of modifiers JW and JZ on single-dose container drugs.
JW modifier: A HCPCS Level II modifier required to be reported on a claim to report the amount of drug that is discarded and is eligible for payment under the discarded drug policy. The modifier should only be used for claims that bill single-dose container drugs.
JZ modifier: A HCPCS Level II modifier reported on a claim to attest that no amount of drug was discarded and is eligible for payment. The modifier should only be used for claims that bill for single- dose container drugs.
Future State: N/A
Applicable Plan(s): Commercial, Medicare and Medicaid
Applicable Policy #: 4007 and 4008
Business Owner: Cost of Care