traceyeh
New
Infusion was stopped due to reaction. The modifier 53 goes on the infusion drug correct?
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Wiki modifier 53
- Thread starter traceyeh
- Start date
If the infusion was stopped quickly, I would look at a push CPT vs infusion CPT - depending on WHEN it was stopped.
I am not aware of any J code where -53 is a valid modifier. You may want to review modifier -JW for the wasted medication.
I am not aware of any J code where -53 is a valid modifier. You may want to review modifier -JW for the wasted medication.
CBLENNIE
Expert
I agree with @csperoni but would like to add on to the statement regarding modifier JW. This modifier can only be used for single use vial drugs so if the medication that was setup to be infused was from a multi-dose vial, then you should not be using modifier JW.
In the 07/27/23 weekly MLN Connects newsletter that was a link to a fantastic FAQ on modifiers JW & JZ, here is the link to the Discarded Drugs & Biologicals - JW & JZ Modifier Policy FAQ. Q7 specifically addresses use of modifier JW for multiple dose containers should not be billed with JW (or JZ). This question all explains that the determination of whether a drug is considered a single-dose vial is based on the FDA approved labeling.
Unfortunately, I don't know of a way to bill for the wasted medication from a multi-dose vial in this situation.
Does anyone with in depth knowledge on billing for medications that are wasted have any insight into what to do about wasted medication from a multi-dose vial due to the scenario posed here?
In the 07/27/23 weekly MLN Connects newsletter that was a link to a fantastic FAQ on modifiers JW & JZ, here is the link to the Discarded Drugs & Biologicals - JW & JZ Modifier Policy FAQ. Q7 specifically addresses use of modifier JW for multiple dose containers should not be billed with JW (or JZ). This question all explains that the determination of whether a drug is considered a single-dose vial is based on the FDA approved labeling.
Unfortunately, I don't know of a way to bill for the wasted medication from a multi-dose vial in this situation.
Does anyone with in depth knowledge on billing for medications that are wasted have any insight into what to do about wasted medication from a multi-dose vial due to the scenario posed here?