Click here for more sample CPC practice exam questions with Full Rationale Answers

Practice Exam

Click here for more sample CPC practice exam questions and answers with full rationale

Practice Exam

CPC Practice Exam and Study Guide Package

Practice Exam

What makes a good CPC Practice Exam? Questions and Answers with Full Rationale

CPC Exam Review Video

Laureen shows you her proprietary “Bubbling and Highlighting Technique”

Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page

Practice Exam

2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

Practice Exam

Click here for more sample CPC practice exam questions and answers with full rationale

New CLIA Waived Tests Effective October 1, 2020

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.

AAPC Knowledge Center

New CLIA Waived Tests – Modifier QW not Required List effective from October 1, 2019


CR 11354 informs MACs of new Clinical Laboratory Improvement Amendments of 1988 (CLIA) waived tests approved by the Food and Drug Administration (FDA). Since these tests are marketed immediately after approval, the Centers for Medicare & Medicaid Services (CMS) must notify the MACs of the new tests so that they can accurately process claims. Make sure your billing staffs are aware of these CLIA-related changes.

CR 11354 presents the latest tests approved by the FDA as waived tests under CLIA. 
The Current Procedural Terminology (CPT) codes for these new tests must have the modifier “QW” to be recognized as a waived test. 

The tests mentioned on the first page of the list attached to CR 11354,do not require a “QW” modifier to be recognized as a waived test. The CPT codes are,

81002 URINALYSIS NONAUTO W/O SCOPE
81025 URINE PREGNANCY TEST
82270 OCCULT BLOOD FECES
82272 OCCULT BLD FECES 1-3 TESTS
82962 GLUCOSE BLOOD TEST
83026 HEMOGLOBIN COPPER SULFATE
84830 OVULATION TESTS
85013 SPUN MICROHEMATOCRIT
85651 RBC SED RATE NONAUTOMATED

The CPT code, effective date, and description for the latest tests approved by the FDA as waived tests under CLIA include,

80305QW, December 13, 2018, Shenzhen Bioeasy Biotechnology Co., Ltd, BIOEASY Multi-Drug Test Cup
80305QW, April 18, 2019, Mercedes Scientific Inc., Platinum+ Multi-Drug Urine Test Cup
80305QW, April 18, 2019, Mercedes Scientific Inc., Platinum+ Multi-Drug Urine Test Dip Card
87880QW, May 9, 2019, McKesson Consult Strep A Test Cassette
87502QW, May 28, 2019, Alere ID NOW Instrument {Nasal and Nasopharyngeal swabs}, for Influenza A/B
87634QW, May 29, 2019, Alere ID NOW Instrument {Nasopharyngeal swabs}, for respiratory syncytial virus


Source: New Waived Tests


Coding Ahead

Newly Waived Lab Tests

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 […]

The post Newly Waived Lab Tests appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

FQHC Billing and Clia waived testing.

Can anyone tell me if they are billing CLIA waived tests at their health centers?
I know they are included in the "encounter rate" for Medicare and will go on the cost report to recoup our costs.
However for all other insurances are you/can you bill the limited CLIA waived tests using the QW and be reimbursed?
What billing procedures are you following in your practices?
If so, how are you determining the costs when the supply cost is so minimal?

Thanks!

Medical Billing and Coding Forum

CLIA Waived Tests Effective January 1, 2017

The Centers for Medicare & Medicaid Services (CMS) has tweaked the tests it says are waived from Clinical Improvement Amendment of 1988 (CLIA), releasing the list effective January 1, 2017. CLIA regulations require a facility to be certified for each test performed. To ensure that Medicare & Medicaid only pay for laboratory tests categorized as waived […]
AAPC Blog

G0478 – CLIA waived test?

I have a provider that was denied by Cigna when trying to add G0477 (urine drug screen) to his contract but they responded and said they are adding G0478. The only difference between the two tests is that G0478 requires the use of a scanner in addition to optical viewing of the test strip to read the results. I have looked to see if G0478 requires a QW modifier and is CLIA waived but see that it is not on the CMS list. I know that initially G0477 was left off the list and later added to be backdated to January 1, 2016 so I’m wondering if anyone has heard if the same will be happening with G0478?

The provider is willing to purchase the scanner so he can bill G0478 but if it is not going to be paid then there’s really no point in spending that money. Please help with any information you have available.

Thank you in advance!!

Medical Billing and Coding Forum | AAPC