Results 1 to 3 of 3

JW modifier for Medicare?

  1. #1
    Question JW modifier for Medicare?
    Medical Coding Books
    Base on the new information on the CMS website do we still use the JW modifier for waste or do we bill for all units together. By reading it sound a little confusing but I could be reading in to it too much. Here is the reading I got from the CMS website:

    (CMS encourages physicians to schedule patients in such a way that they can use drugs most efficiently. However, if a physician must discard the remainder of a vial or other package after administering it to a Medicare patient, the program covers the amount of drug discarded along with the amount administered. To submit a claim when a portion of the drug supplied is unused (discarded), include the total of both the unused and the used portion in the days/units field when reporting the dosage. )


    tdplair

  2. Default
    If you include the JW modifier on units that are not used, then there is some amount of reimbursement. For example, if its a VIAL of medicine with 50 ml and only 45 is used on the patient, then you are allowed to be reimbursed for the remaining 5 ml with the JW modifier since the vial is not going to be reused for another patient and the facility has to pay for the whole vial.

    Simone

  3. #3
    Location
    Alexandria, LA
    Posts
    518
    Default
    Quote Originally Posted by tonplair@gmail.com View Post
    Base on the new information on the CMS website do we still use the JW modifier for waste or do we bill for all units together. By reading it sound a little confusing but I could be reading in to it too much. Here is the reading I got from the CMS website:

    (CMS encourages physicians to schedule patients in such a way that they can use drugs most efficiently. However, if a physician must discard the remainder of a vial or other package after administering it to a Medicare patient, the program covers the amount of drug discarded along with the amount administered. To submit a claim when a portion of the drug supplied is unused (discarded), include the total of both the unused and the used portion in the days/units field when reporting the dosage. )
    Each Medicare contractor decides whether or not to require JW. Some do, some don't, others don't require it but let you use it anyway. If your quote is from your local Medicare contractor, then it appears that they do not want the JW modifier, they just want it all totaled together.

Similar Threads

  1. Medicare Modifier 59 changes
    By treinemer in forum Modifiers
    Replies: 2
    Last Post: 09-12-2013, 05:14 PM
  2. Modifier 25 with Medicare
    By kmcdougald in forum Modifiers
    Replies: 2
    Last Post: 06-08-2012, 06:59 AM
  3. medicare modifier
    By genawaller in forum Modifiers
    Replies: 1
    Last Post: 12-19-2011, 11:33 AM
  4. AI modifier - Medicare only?
    By pkidd in forum Modifiers
    Replies: 4
    Last Post: 02-13-2010, 08:50 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.