Q&A JW modifier

[KarenR]

Can you show how to post kenalog j3301 on 2 lines if you have waste. Let's say you have 1.5 cc of kenalog or 1.5ml with .5 waste . Please show how to post the amount quantity administered and amount wasted. J3301 1.5. Ml. Quality 6. And. J3301 .5 ml quantity. 2. With the JWmodifier . Also please advise how to show quantity when the quantity is .5 ml uses and .5 ml wasted with JW . The kenalog 40 shows quantity 1 for 1 ml. Thanks

 

[Paul A]

Kenalog 40 is 40 mg per mL
J3301 is 1 unit per 10mg

If its a 2 mL vial (I thought it only came in 1, 5 & 10) and only 1.5 mL was administered

Line 1) J3301 x 6 for the 60 mg administered
Line 2) J3301-JW x 2 for the 20 mg wasted

If its a 1 mL vial and only half was used

Line 1) J3301 x 2 for the 20 mg administer
Line 2) J3301-JW x 2 for the 20 mg wasted

Now if the amount wasted is less than 1 billable units worth you would not bill for the wasted amount on a second line of it would cause an overpayment.


CGS Website has a good write up on how to bill

http://www.cgsmedicare.com/parta/pubs/news/2015/0315/cope28531.html

Note: When the billing units are equal to or greater than the total actual dose and the amount discarded, HCPCS modifier JW may not be submitted.

Example: One billing unit for a drug is equal to 10 mg of the drug in a single use vial.

• A 7 mg dose is administered to a patient.
• 3 mg of the remaining drug is discarded.
• The 7 mg dose is billed using one billing unit that represents 10 mg on a single line item. The single line item of 1 unit would be processed for payment of the total 10 mg of drug administered and discarded.
• Billing another unit on a separate line item with HCPCS modifier JW for the discarded 3 mg of drug is not permitted because it would result in overpayment.