Policy Updates Reimbursement PoliciesCommercialOctober 31, 2023

Reimbursement policy update: Pharmaceutical Waste – Professional and Facility

Effective September 13, 2023, the Related Coding section of the Pharmaceutical Waste – Professional and Facility reimbursement policy was updated to include Modifier JZ (zero drug amount discarded or not administered to any patient) as a new informational modifier.

As a reminder, the intent of this policy is to require providers to use the most cost-effective vial or combination of vials of pharmaceutical when procuring and preparing a dose for administration to avoid pharmaceutical wastage. This applies to any non-self-administered drug or biologic dosage prepared from a single-dose vial (SDV).

For specific policy details, visit anthem.com/provider/policies/reimbursement/?cnslocale=en_US_ga

MULTI-BCBS-CM-040985-23

PUBLICATIONS: November 2023 Provider Newsletter