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Effective Date for Mandatory Use of JW Modifier Changes from July 1, 2016 to January 1, 2017

Jun 16, 2016

Effective January 1, 2017, when processing claims for Part B drugs and biologicals (except those provided under CAP), the use of the JW modifier to identify unused drugs or biologicals that are appropriately discarded is required. Also, effective January 1, 2017, providers are required to document the discarded drug or biological in the patient's medical record. The Centers for Medicare & Medicaid Services (CMS) is removing the contractors’ discretion to determine whether the JW modifier is required for claims with discarded drugs and biologicals.

The JW modifier is not used on claims for CAP drugs and biologicals. CMS encourages physicians, hospitals, and other providers and suppliers to care for and administer drugs and biologicals to patients in such a way that they can use drugs or biologicals most efficiently, in a clinically appropriate manner.