General Question for the Week of February 3, 2025

Question:

Do you have any more tips for reporting the JZ modifier?

Answer:

Providers should implement a sound practice to code and bill the applicable units based on the entire package administered and documentation should reflect the entire dosage was administered to the patient. It is not recommended to apply JZ modifier as an alternative to JW modifier when it is not apparent in the infusion record or medication administration record (MAR) whether the entire amount of single-dose or single-use drug was used. Meaning, if the documented total amount/dose administered does not equal the number of units for the entire container or package, and the clinician fails to document any discarded/wasted drug, it would not be appropriate to apply modifier JZ to the HCPCS code.

Make sure applicable staff are educated on where in the patient record to document for any discarded/wasted drug so that coding and billing staff can validate the total dosage against the billing units to determine if modifier JW or JZ is applicable. Providers can expect line-item denials when the billed drug HCPCS code assigned to the single-dose or single-use container and package does not contain one of these modifiers.

This question was answered in our Coding Essentials for Infusion & Injection Therapy Services. For more hot topics relating to infusion services, please visit our store or call us at 1.800.252.1578, ext. 2.