Required Use of JW and JZ Modifiers Begins Oct. 1

The Centers for Medicare and Medicaid Services (CMS) will enforce use of the JW modifier or JZ modifier for all claims for drugs from single-use vials or single-use packages payable separately under Medicare Part B beginning Oct. 1. 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.

• The JW modifier is used to identify any discarded amounts.
• The JZ modifier is used to attest that there were no discarded amounts.

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. Practices will have the opportunity to correct claims to be reprocessed.

The American College of Radiology®(ACR®), the Radiology Business Management Association, RadNet and RayUS met with CMS earlier this month to voice concerns regarding the imminent 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 enforcement date. The ACR will continue to update members if there are any changes to this policy.

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

For additional information, contact Christina Berry, Team Lead, Economic Policy.