Article Detail - JE Part A

This coverage article has been revised and published for notice under contract numbers: 01111 (CA), 01211 (AS, GU, HI, NMI), 01311 (NV), and 01911 (CA, HI & Territories).

Effective Date: January 10, 2023

Summary of Article Changes:

Updated Article Billing and Coding: JW and JZ Modifier Billing Guidelines

Updated guidance in the Article Text section:

• Changed the sentence: "This article addresses the required use of the JW and JZ modifier to indicate drug wastage."
• Added: "Effective July 1, 2023, Medicare requires the JZ modifier on all claims for single-dose containers where there are no discarded amounts."
• Added: 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
• Removed MLN Matter Article MM9603 under sources as this is no longer published.
• Updated Title of Source #3: Discarded Drugs and Biologicals - JW Modifier and JZ Modifier Policy Frequently Asked Questions (cms.gov)

Updated CPT/HCPCS Modifier: added JZ modifier

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