Billing and Coding: JW Modifier Billing Guidelines (A55932) - R4 - Effective January 10, 2023

This coverage article has been revised and published for notice under contract numbers: 02102 (AK), 02202 (ID), 02302 (OR), 02402 (WA), 03102 (AZ), 03202 (MT), 03302 (ND), 03402 (SD), 03502 (UT), and 03602 (WY).

Effective Date: January 10, 2023

Summary of Article Changes: Updated guidance in the Article Text section: changed the sentence, "The units billed must correspond with the smallest dose (vial) available for purchase from the manufacturer(s) that could provide the appropriate dose for the patient, while minimizing any wastage." to "The units billed should where possible correspond with the smallest dose (vial) available for purchase from the manufacturer(s) that could provide the appropriate dose for the patient, while minimizing any wastage."

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Last Updated Jan 23 , 2023