Pharmacy Question for the Week of June 25, 2018

Pharmacy Compliance Question of the Week

Question:

Can modifier JW be assigned when the dose administered is less than the HCPCS billing unit?

Answer:

The Centers for Medicare & Medicaid Services (CMS) does not use fractional billing units to pay for Part B drugs. Therefore, the JW modifier should not be used when the actual dose of the drug administered is less than the HCPCS billing unit.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.