Forum - Questions & Answers

Jun 14th, 2016 - dlstoner512 1 

JW Modifier, billing patient for wastage

Cigna was billed for the medication and for the medication wasted from a single dose vial (JW modifier was used). Cigna applied to the patient's deductible for both the medication given and the medication wasted. The patient is protesting paying for the medication not given (I understand his point), but I also know that we're contracted with Cigna and are responsible for collecting his deductible. Has anyone run into this situation? I would appreciate any guidance.

Jun 14th, 2016 - LBAROGIANIS 250 

re: JW Modifier, billing patient for wastage

How much was the dosage of the whole vial? How much was used on the patient? Most likely if you just billed the normal vial then Cigna would have paid that line item. Is Cigna requiring you to use the JW modifier? If the vial is 10mg and you only used 7mg, but you have billed the first line item normal... then Cigna already paid for it. It seems that you are billing twice if you bill the second line item for 3mg. Just my opinion.

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