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Supplement 24-17: Billing and Coding Discarded or No Discarded Drugs and Biologicals with a JW or JZ Modifier

New Mexico Medicaid·NM·Claims & Billing
Effective date
Jul 1, 2023
We identified it
Jun 21, 2026
Days to comply

Summary

New Mexico Medicaid now requires providers to use JW modifier when reporting discarded drug amounts from single-dose containers, or JZ modifier when no drug is wasted. This applies to all single-dose drugs and biologicals billed with HCPCS or CPT codes, requiring separate claim lines for administered and discarded portions.

Action Required

Action needed
Immediately for New Mexico Medicaid claims: Billing team must update claim submission process to include JW modifier on separate claim line for any discarded drug amounts from single-dose containers, or JZ modifier when no waste occurs. Update CMS-1500 forms to include NDC codes in box 24A with N4 qualifier and appropriate modifiers in box 24D. Update UB-04 forms to include NDC in box 43 and JW/JZ modifiers in box 44 after procedure codes. Train staff to document administered and discarded amounts in medical records. Claims missing required modifiers may be denied.