Health Information Management

Tip: CMS added two new modifiers effective April 1

APCs Insider, June 26, 2015

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As part of the April quarterly OPPS update, CMS added two new modifiers valid April 1:
  • -JF, compounded drug
  • -EX, expatriate beneficiary
CMS added modifier -JF after the release of an Office of Inspector General (OIG) report in 2014 that noted the agency and MACs could not track the number of claims or amount paid for compounded drugs under Medicare Part B. OIG recommended that CMS implement a way to collect more information on these drugs to distinguish them from other drugs that may be reported under "not otherwise classified" codes.
This tip is adapted from “April I/OCE update continues to clarify comprehensive APC process" in the June issue of Briefings on APCs.

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