Medicare Compliance & Reimbursement

Question: Even though modifier JZ was introduced last January, we’re a little confused about it. How should we use it, and when did Medicare actually start to monitor its use?

Texas Subscriber

Answer: On Jan. 1, 2023, the Centers for Medicare & Medicaid Services (CMS) introduced modifier JZ (Zero drug amount discarded/not administered to any patient). Unlike modifier JW (Drug amount discarded/not administered to any patient), which you use when the provider administers part of a single-dose container and discards the rest, Medicare instructed you to use the JZ modifier when the entire container is used as the dose administered and there is no discarded amount subject to modifier JW rules.

Even though modifier JZ had an effective date of Jan. 1, 2023, CMS opted to give providers until July 1 to start using it. On Oct. 1, 2023, Medicare then began claims processing edits, checking use of both JW and JZ.

Tip: You should add the JZ modifier to the HCPCS Level II code claim line and include the number of units administered in the units field, according to the HCPCS Level II code definition.