Gastroenterology Coding Alert

Reader Questions:

Modifiers 53, JW Leave No Procedure Wasted

Question: We perform Remicade infusions in our office. We typically report J1745 (for the medication) along with other procedure codes. A patient was supposed to receive three vials of medication but received only one when the physician decided she could not complete the infusion because of an unexpected problem that threatened the patient's safety. Two vials were left unused. How should I report the situation? How about appending modifier JW to describe waste in medication?Answer: First, if the total infusion time was less than one hour you should report the infusion service with code 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug).To report for a portion of a vial of injected medication that must be discarded as waste, you should add modifier JW to the HCPCS medication code. Remember to indicate the number of units discarded and the calculated submitted price for the amount [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Gastroenterology Coding Alert

View All