CMS Mandates Use of JW and JZ Modifiers Beginning Oct. 1

The Centers for Medicare and Medicaid Services (CMS) will enforce use of the JW or JZ modifiers for all claims for drugs from single-use vials or single-use packages payable separately under Medicare Part B beginning Oct. 1. The JW modifier will be used to identify any discarded amounts, and the JZ modifier to attest that there were no discarded amounts. This mandate includes drugs excluded from the definition of “refundable single-dose container or single-use package,” such as radiopharmaceuticals and contrast agents used in medical imaging.

Also beginning Oct. 1, claims for drugs from single-dose containers that do not appropriately use the JW/JZ modifiers will be returned as un-processable until claims are properly submitted.

The American College of Radiology®(ACR®), the Radiology Business Management Association, RadNet and RayUS met with CMS to voice concerns regarding the impending enforcement of this policy. The College and stakeholders asked CMS to waive the JW/JZ reporting requirement for imaging contrast agents and radiopharmaceuticals prior to the Oct. 1 enforcement date.

For additional information about this policy, refer to the CMS FAQ on the JW Modifier and JZ Modifier.

If you have questions, contact Christina Berry, ACR Team Lead, Economic Policy.