JW, JZ: Drug dosing modifiers

Drug Amount Discarded/Not Administered to any Patient

The JW modifier is used to identify discarded doses or quantities of the drug or biological from a single-use vial or single-use packaging. We’ve adopted the CMS guidelines associated with use of the JW modifier, noted below.

JW modifier guidelines

  • Report the drug code on two claims lines (see below). Total units for both lines shouldn’t exceed units defined for HCPCS code.
  • Dosage or quantity reported as waste should be discarded and not administered to another member.
  • Medical record must support actual dosage administered along with the actual waste or discarded units.
  • Units reported must correspond with the smallest dose (vial) available from drug manufacturer or pharmacy for purchase. This allows for minimal waste or discarded drug or biological.

Incorrect reporting

  • Multi-dose vial: JW reported with multi-dose vials will deny for inappropriate modifier use
  • JW modifier isn’t appropriate when the actual dose of the drug or biological administered is less than the billing unit


Modifier JZ guidelines

Definition: zero wasted

Priority Health will align with Medicare , effective July 1, 2023, all providers and suppliers are required to report the JZ modifier on all claims that bill for drugs from single-dose containers that are separately payable under Medicare Part B when there are no discarded amounts. Both modifiers JW and JZ do not apply to drugs that are not separately payable, such as packaged OPPS or ASC drugs, or drugs administered in the FQHC or RHC setting.

Report the drug code on one claim line with the HCPCS code and modifier JZ. Total units administered in the unit field.

Appropriate Use

  • The drug or biological administered is a single-dose vial or package
  • Did not discard any unit of service Drugs assigned status indicators “G” (Pass-Through Drugs and Biologicals)
  • Drugs assigned status indicators “K” (Nonpass-Through Drugs and Nonimplantable Biologicals, Including Therapeutic Radiopharmaceuticals)
  • Drugs assigned status indicators “K2” (Drugs and biologicals paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate)

Inappropriate Use

Do not use in the following circumstances:

  • The drug or biological provided in a multi-does vial or package
  • You discarded one or more units of service for a single-dose vial or package