New CTP Coding Requirement

Cellular Tissue Products

Effective July 1, 2023, providers must report the JZ modifier when the entire cellular and/or tissue-based product (CTP) (previously called “skin substitute”) is applied to a Medicare Part B beneficiary and there is no waste.[1]

Providers have always had to document the amount of the CTP used and wasted, using square centimeters to quantify units.  Starting January 1, 2017, providers were required to also code the number units of used and number of units wasted for Medicare Part B beneficiaries, by listing the product code on two lines, one with the number of units used and the other with the number of units wasted.  Along with this, providers were instructed to append a JW Modifier to the line that indicated the number of units wasted.  Under this direction, if a provider only submitted one line of the product code with all units, it was assumed all of the product was used and there was no waste. After July 1, the JZ modifier will be used to specifically indicate that there was no wastage if such is the case.

By way of example, starting July 1, 2023, if 25 sq cm of a 25 sq cm CTP is used and there is no waste, the appropriate product coding for a Medicare Part B beneficiary would be:

  • Qxxxx – 25 units – JZ Modifier

If, however, 20 units of a CTP is used and 5 units are wasted, the appropriate product coding for a Medicare Part B beneficiary would be:

  • Qxxxx – 20 units
  • Qxxxx – 5 units – JW Modifier

No “J” Modifier would be appended to the line with 20 units.

Jeffrey D. Lehrman, DPM, FASPS, MAPWCA, CPC, CPMA

Dr. Lehrman is a Board Certified Podiatrist, Certified Professional Coder, and Certified Professional Medical Auditor. He is in private practice in Colorado and operates Lehrman Consulting, LLC which provides consultation services regarding coding, compliance and documentation.

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