QW modifier

[rthames052006]

Hello all,

I am at a new employer now and I am unsure as to why they are using the QW modifier for Medicare claims when they bill a cpt code in the 80000 series, where I used to work we billed for those codes and we never had to use this QW modifier, when I asked why we are using it and what it means because I have never heard of it. I am being told because they were told to, no one knows why but they just do.

I just want to get some clarification on this, since I have no prior experience with it.

I think I will also check my local medicare carrier website to see if I can get a clue.

TIA

[rthames052006]

Ok, so I checked Medicare's website and I now know that QW= clia waived test, but I am still unclear, I don't mean to sound stupid but the office I came from this wasn't an issue, and at this point no one can tell me why we have to use it... I'm just looking to get some clarification....

Any help will be appreciated.

Originally Posted by rthames052006

Hello all,

I am at a new employer now and I am unsure as to why they are using the QW modifier for Medicare claims when they bill a cpt code in the 80000 series, where I used to work we billed for those codes and we never had to use this QW modifier, when I asked why we are using it and what it means because I have never heard of it. I am being told because they were told to, no one knows why but they just do.

I just want to get some clarification on this, since I have no prior experience with it.

I think I will also check my local medicare carrier website to see if I can get a clue.

TIA

[jharrell]

We put the QW on some of our 80000 codes that we do in house. We have always wondered if they are suppose to go on all as well and have always been told what you are being told. So I went to look it up and go to the following link and I think this may help. Starting on the 5th page it gives you a list of the codes that require the QW.

Jessica Harrell, CPC

[thompsonsyl]

Hi,

CLIA stands for "clinical laboratory improvement amendments". It is a law that establishes quality standards for all laboratory testing (except research) to ensure the accuracy, reliability and timeliness of patient tests. There are all sorts of guidelines & criteria that a "laboratory" must meet. As per CLIA, the definition of a "laboratory" is as follows: "a facility that performs testing on materials derived from the human body for the purpose of providing information for the diagnosis, preventionm, or treatment of any disease or impairment of, or assessment of the health of, human beings."

There are different levels of certificates that are required in order for a facility to do lab tests. The QW modifier states that the tests you are performing are "simple laboratory examinations and procedures that have an insignificant risk of an erroneous result". They are considered "CLIA waived" and therefore require a "CLIA Certificate of Waiver". You can access a complete list of the CLIA waived tests via the link I've included below.

This in a nutshell, I think answers some of your questions. There is more in-depth information that you can find on the CLIA webiste. I've included the link for you below:

http://www.cms.hhs.gov/CLIA/01_Overview.asp#TopOfPage

Hope this helps & Good Luck.

[jharrell]

http://www.cms.hhs.gov/transmittals/...ads/R325CP.pdf

Sorry here is the link I was talking about

[rthames052006]

thompsonsyl,

Thank you very much for the info... I appreciate your prompt, clear response, it all makes sense now.

Again thanks

Originally Posted by thompsonsyl

Hi,

CLIA stands for "clinical laboratory improvement amendments". It is a law that establishes quality standards for all laboratory testing (except research) to ensure the accuracy, reliability and timeliness of patient tests. There are all sorts of guidelines & criteria that a "laboratory" must meet. As per CLIA, the definition of a "laboratory" is as follows: "a facility that performs testing on materials derived from the human body for the purpose of providing information for the diagnosis, preventionm, or treatment of any disease or impairment of, or assessment of the health of, human beings."

There are different levels of certificates that are required in order for a facility to do lab tests. The QW modifier states that the tests you are performing are "simple laboratory examinations and procedures that have an insignificant risk of an erroneous result". They are considered "CLIA waived" and therefore require a "CLIA Certificate of Waiver". You can access a complete list of the CLIA waived tests via the link I've included below.

This in a nutshell, I think answers some of your questions. There is more in-depth information that you can find on the CLIA webiste. I've included the link for you below:

http://www.cms.hhs.gov/CLIA/01_Overview.asp#TopOfPage

Hope this helps & Good Luck.

[taham]

I need to know do we use qw modifire for lab test only for medicare patient.