Skip to main content
Shop Plans Learn more about our coverage options including health, Medicare, dental and vision options for you, your family or your employees. Get Started Individual & Family Medicare Employer Vision Dental International Travel Find Care FAQ Blog Members Stay on top of your health care with helpful member resources. Members Home Medicare Health Dental Vision Find Care Member Knowledge Center Member Forms Medicare Forms Library Make a Payment Federal Employees Student Blue Healthy Blue Providers Access tools, policies and the latest information to help you care for our members. Providers Home Network Participation Networks & Programs Claims, Appeals & Inquiries Prior Authorization Services & CPT codes Prescription Drug Search Policies, Guidelines & Codes Provider News Provider FAQ Contact Us Employers Learn about our coverage options for small and large employers, and access tools and resources for your group. Employers Home Shop Employer Plans Employer Portal Support Member Forms & Resources Find Care Blog Agents Access the tools you need: rate quotes, applications, forms, the latest industry news, marketing materials and more. Agents Home Agent Services Check Eligibility Find Care Member Forms & Resources Medicare Forms Library
Contact Us
Log In
I am ... Please select A member A provider An employer An agent
Log in to Agent Services
Log in to Employer Services Register for Employer Services I'm registered but need portal access
Username Forgot username? Continue to Log In Register for Blue Connect Need help? Learn how to log in.
Log in to Blue e Register for Blue e Log in to Dental Blue
Back
Update: Reimbursement Policy Update: Some Modifier JZ/JW Claims to be Reprocessed February 21, 2025 Claims & Coding

Update February 21, 2025: Recently, Blue Cross NC identified and fixed a temporary issue that caused denials for some claims that appropriately used the JW/JZ modifier. Any claims denied between November 1, 2024 and January 31, 2025, and appropriately used a JW/JZ modifier, will automatically be reprocessed. There is nothing providers need to do at this time.

Our policy remains the same, and Modifier JW or JZ is required on claims for single-use vial or package of drugs or biologicals. Additional information and examples of when a JZ or JW modifier is appropriate was posted here.

This processing error impacted Commercial, Inter-Plan Program (IPP) Host and Medicare Advantage.  

 


 

Effective November 1, 2024, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is implementing a revision to the reimbursement policy Drugs and Biologicals. 

Consistent with CMS, Modifier JZ will now be required for a single-use vial or package when there is no discarded/wasted drug or biological. Modifier JW will continue to be required when there is discarded/wasted drugs or biologicals from a single use-vial or package. 

In general, Modifier JW or JZ will be required on claims for single-use vial or package of drugs or biologicals. Failure to include Modifier JW or JZ will result in claim denial. Please see the related policy notification for more information.

This Modifier JZ requirement will ensure wastage is accurately coded on the claim – providing more insight and clarity into drug wastage and improving claim adjudication accuracy.

This change will apply to Commercial, Inter-Plan Program (IPP) Host, State Health Plan, Senior Market Administration (SMA), and Federal Employee Program (FEP). This will not apply to IPP Home.