You should be aware of the use of the new JZ modifier for Medicare Part B drugs from a single-dose container or single-use package.
Effective July 1, 2023, you must report the JZ modifier on all claims that bill for drugs separately payable under Part B when there is no discarded amount from single-dose containers or single use packages. For the amount you administer, the claim line should include the billing and payment code, such as a HCPCS code, describing the given drug, the JZ modifier showing there were no discarded amounts, and the number of units administered in the units’ field.
Per the Medicare FAQ:
Q1. What is the JW modifier?
A1. The JW modifier is a Healthcare Common Procedure Coding System (HCPCS) Level II modifier required to be reported on a claim to report the amount of drug that is discarded and eligible for payment under the discarded drug policy. The modifier should only be used for claims that bill single-dose container drugs.
Q2. What is the JZ modifier?
A2. The JZ modifier is a HCPCS Level II modifier reported on a claim to attest that no amount of drug was discarded and eligible for payment. The modifier should only be used for claims that bill for single-dose container drugs.
To align with the JW modifier policy, the JZ modifier is required when there are no discarded amounts of a single-dose container drug for which the JW modifier would be required if there were discarded amounts.
There are no changes regarding the reporting of the JW modifier.
The JZ modifier is being implemented in phases:
January 1, 2023: You may report the JZ modifier.
July 1, 2023: You are required to use the JZ modifier on applicable claims.
October 2, 2023: Claims editing starts when JW or JZ modifiers are not used correctly.
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