Wiki Medication reporting for Modifier JZ

[areinart]

Due to the new medicare guidelines with modifiers JZ and JW, IF the user administers more than one single use vial for a patient, how does this need to be reported? would each 'vial' need to be reported on separate claim lines?

 

[iowagirl77]

Combine the total amount of vials administered on one line. You would only need to split lines to indicate the amount of waste on a separate line.

Per CMS https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55932 :

Claim line #1:

• HCPCS code for drug given
• No modifier
• Number of units given to the patient
• Calculated submitted price for ONLY the amount of drug given

Claim line #2:

• HCPCS code for drug wasted
• JW modifier to indicate waste
• Number of units wasted
• Calculated submitted price for ONLY the amount of drug wasted

To submit claims for a non-discarded claim, submit one complete claim line.

• HCPCS code for drug given
• JZ modifier to indicate no waste
• Number of units given to the patient
• Calculate submitted price for the amount given