Discarded Drugs – Updated Change Request from CMS

Effective Date July 1, 2016 There has been a change in CMS policy regarding the use of the JW modifier (JW Drug amount discarded /not administered to any patient). Discarded drugs must be reported on a separate line item from the line item for the administered drug. Assign Modifier JW to the HCPCS code that identifies the amount discarded…

It is important to note that if the amount discarded is less than the described dose by the HCPCS code the JW modifier is not permitted. In other words, if the amount discarded is less than a billing unit then JW cannot be assigned.

CMS requires:

  • Name of the drug
  • Route of administration
  • Dosage
  • Duration of administration (if time-based)
  • When a portion of the discarded drug is discarded from a single use vial, the medical record must include the amount administered and the amount discarded.

Important notes:

  • Only discarded drugs from a single dose vial may be reported.
  • Non-administered portions of a multi-dose vial are not billed.
  • Exception: JW modifier is not used on Competitive Acquisition Program (CAP) claims.

(Per CMS, JW can be assigned for discarded drugs or biologicals)