Q&A: How to ensure appropriate drug waste modifier use on skin substitute claims

Q: How can we improve correct use of drug waste modifiers on skin substitute claims?

A: One of the most common errors seen in skin substitute claims is the inappropriate application of drug waste modifiers, which are as follows:

• -JW (Drug amount discarded/not administered to any patient)
• -JZ (Zero drug amount discarded/not administered to any patient)

Organizations should train coders on CMS’ drug waste modifier policy and consider implementing claim scrubbers to flag missing or incorrect modifiers before submission, says Betty A. Hovey, BSHAM, CCS-P, CDIP, CPC, COC, CPMA, CPCD, CPB, CPC-I, senior consultant and owner of Compliant Health Care Solutions in Port Charlotte, Florida.

Organizations need to validate that the amount of units billed corresponds with the amount of units applied, says Hall.

“Encourage coders to cross-reference operative reports and supply logs to confirm that product usage aligns with the code reported,” she says.

Hovey recommends working with IT teams to develop an EHR prompt to ensure precise measurements get captured, as many facilities misreport the number of applied or discarded units. For example, they may bill for the entire product size when only a portion was used, or fail to adjust to payer-specific unit calculations.

“Train staff to document exact square centimeters applied and discarded, and verify units against payers’ billing rules,” she says.

Editor’s note

This article was excerpted from “Ensuring appropriate coding and documentation for skin substitute claims” in the July 2025 issue of the NAHRI Journal. The NAHRI Journal, published each quarter in January, April, July, and October, is a benefit of NAHRI membership. Not a member? Become one today!