What CPT codes need QW modifier?
Providers possessing a Clinical Laboratory Improvement Amendments (CLIA) Certificate of Wavier or Provider – Performed Microscopy Procedures (PPMP) must utilize a test kit and bill the program utilizing a QW modifier with for the following codes: 80061, 80101, 81003, 81007,82010, 82044, 82055, 82120, 82273, 82274.
What is modifier QW used for?
Modifier QW is used to indicate that the diagnostic lab service is a Clinical Laboratory Improvement Amendment (CLIA) waived test and that the provider holds at least a Certificate of Waiver. The provider must be a certificate holder in order to legally perform clinical laboratory testing.
What CPT codes are CLIA waived?
CLIA Waived Tests List CPT Codes
- CPT 81002: URINALYSIS NONAUTO W/O SCOPE.
- CPT 81025: URINE PREGNANCY TEST.
- CPT 82270: OCCULT BLOOD FECES.
- CPT 82272: OCCULT BLD FECES 1-3 TESTS.
- CPT 82962: GLUCOSE BLOOD TEST.
- CPT 83026: HEMOGLOBIN COPPER SULFATE.
- CPT 84830: OVULATION TESTS.
- CPT 85013: SPUN MICROHEMATOCRIT.
What is Medicare QW modifier?
CLIA-waived
Medicare uses modifier QW to indicate that a test is CLIA-waived and the reporting physician’s practice has a CLIA certificate that allows the physician to perform and report CLIA-waived tests.
What is CLIA-waived?
What is waived testing? By the CLIA law, waived tests are those tests that are determined by CDC or FDA to be so simple that there is little risk of error. Some testing methods for glucose and cholesterol are waived along with pregnancy tests, fecal occult blood tests, some urine tests, etc.
What does CLIA stand for?
Clinical Laboratory Improvement Amendments of 1988
“CLIA” is the acronym for the Clinical Laboratory Improvement Amendments of 1988. This law requires any facility performing examinations of human specimens (e.g., tissue, blood, urine, etc.) for diagnosis, prevention, or treatment purposes to be certified by the Secretary of the Department of Health and Human Services.
What are examples of CLIA waived tests?
As defined by CLIA, waived tests are “simple laboratory examinations and procedures that have an insignificant risk of an erroneous result.” Examples of waived tests include: dipstick urinalysis, fecal occult blood, urine pregnancy tests, and blood glucose monitoring.
What is CLIA in medical billing?
The Clinical Laboratory Improvement Amendments (CLIA) regulate laboratory testing and require clinical laboratories to be certified by the Center for Medicare and Medicaid Services (CMS) before they can accept human samples for diagnostic testing. Each agency has a unique role in assuring quality laboratory testing.
Are CLIA waived tests payable?
Notably, Medicare pays only for laboratory tests categorized as waived complexity under CLIA in facilities with a CLIA certificate of waiver.