Pharmacy Question for the Week of April 3, 2017


I thought it was Medicare payers that decided whether modifier JW was required on claims but ours says it is not responsible for this decision. Can you provide information on this?


Effective January 1, 2017, contractors no longer have discretion to determine whether the JW modifier is required for Part B claims. According to policy from the Centers for Medicare & Medicaid Services (CMS), providers and suppliers are required to report the JW modifier for discarded drugs and biologicals billed on outpatient claims. Providers and suppliers must comply with medical record documentation requirements for recording the amount of discarded and dose administered.

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