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Medicare beneficiaries will be able to get over-the-counter COVID-19 tests at no cost starting in early spring. A new Medicare initiative will soon allow Original Medicare and Medicare Advantage beneficiaries to receive up to eight over-the-counter (OTC) COVID-19 tests per month for free. This initiative, announced last month by the Centers for Medicare & Medicaid […]
The post Medicare to Cover Free Over-the-Counter COVID Tests appeared first on AAPC Knowledge Center.
Review the AMA’s updated definition of what constitutes a unique test. Many coders are asking the question, “What is a unique test?” As always, we must first turn to the guidelines to see how “test” is defined. In the original published guidelines, the American Medical Association (AMA) stated: “Tests are imaging, laboratory, psychometric, or physiologic […]
The post 2021 E/M Changes: Are You Coding Unique Tests Properly? appeared first on AAPC Knowledge Center.
BCBS and other payers weigh in on at-home testing. In the recent article FDA Authorizes Non-Prescription COVID Tests, AAPC reported that the U.S. Food and Drug Administration (FDA) has granted emergency use authorization for at-home, over-the-counter (OTC) COVID-19 tests. On March 5, 2021, Cue Health received emergency use authorization (EUA) from the FDA for their […]
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The FDA grants emergency use authorization for at-home, over-the-counter COVID-19 tests. On March 5, 2021, Cue Health received emergency use authorization (EUA) from the U.S. Food and Drug Administration (FDA) for their Cue COVID-19 Test for Home and Over The Counter (OTC) Use. The nucleic acid amplification test (NAAT) detects the RNA of SARS-CoV-2, the […]
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Labs soon will have to work harder to merit the maximum allowed Medicare payment for high-throughput tests used to detect SARS-CoV-2. The Centers for Medicare & Medicaid Services (CMS) has been paying labs $ 100 per test — up from $ 51 — since a public health emergency (PHE) for COVID-19 was declared on March 18, 2020. […]
The post COVID Tests Worth Less in 2021 appeared first on AAPC Knowledge Center.
There are five newly-added waived complexity tests under the Clinical Laboratory Improvements Amendments of 1988 (CLIA). These tests go into effect Oct. 1 and will be implemented by Medicare Administrative Contractors by Oct. 5. CLIA regulations require a facility to be certified for each test performed. To ensure that Medicare and Medicaid only pay for […]
The post New CLIA Waived Tests Effective October 1, 2020 appeared first on AAPC Knowledge Center.
Using 87804 x 2 might result in denial. If you’re performing a test that detects the flu via immunoassay in the office, your provider might test for two strains of the virus. Impact: When you file these claims properly, you’ll be paid for two flu tests rather than one. Read on for a bit of knowledge […]
The post Get Multiple Flu Tests Paid appeared first on AAPC Knowledge Center.
Source: New Waived Tests
My physicians order lab tests routinely for their patients. Most of the time, I see what was ordered at the bottom of their progress note. The problem I’m having is there is no diagnosis information listed for each test. Some of them are self-explanatory like testing A1C for DM but other times it is not clear what the primary reason is for doing the test. My question is, does every lab test order in the EHR need the diagnosis code or the reason why the test is being done? Any help you can provide would be helpful!
Thanks!
Mary
Clinical diagnostic laboratories submitting claims to Medicare should be aware of 12 new tests recently approved by the FDA. The new Clinical Laboratory Improvement Amendments of 1988 (CLIA) waived tests are shown in Table 1. Table 1: New Waived Tests Requiring QW Modifier (MLN Matters MM11231) CPT® Code Effective Date Description 80305QW September 14, 2018 […]
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