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CMS Revises JW Modifier Rule

May 31, 2016

The Centers for Medicare & Medicaid Services (CMS) has updated their rule for using the JW modifier when discarding unused drugs from a single-use file. It is no longer voluntary, but mandatory beginning July 1, 2016. Providers must:

  • Use the JW modifier for claims with unused drugs or biologicals from single use vials or single use packages that are appropriately discarded (except those provided under the Competitive Acquisition Program (CAP) for Part B drugs and biologicals) and
  • Document the discarded drug or biological in the patient's medical record when submitting claims with unused Part B drugs or biologicals from single use vials or single use packages that are appropriately discarded

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