CMS Adds Two Codes to CLIA Edits

The Centers for Medicare & Medicaid Services (CMS) recently added to the list of laboratory and pathology codes subject to Clinical Laboratory Improvement Amendments (CLIA) regulations, which require a facility to be appropriately certified for each test performed. Facilities should be aware of two CPT® codes used to report the professional and technical components of cytopathology that were inadvertently omitted in a previous communication.

According to CMS Transmittal 915, Change Request (CR) 7513, issued July 22, the following two CPT® codes are subject to CLIA edits, retroactively effective Jan. 1, 2011:

88120  Cytopathology, in situ hybridication (e.g., FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual

88121  Cytopathology, in situ hybridication (e.g., FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology

The edits apply to Medicare Part B claims for both the professional (modifier 26 Professional component) and technical component (modifier TC Technical component) of laboratory services.

Latest posts by admin aapc (see all)

Read the complete Article

Login as a member or sign up for free to get uninterrupted access to AAPC blog posts and stay updated on industry news through our monthly newsletter.

2017-code-book-bundles-728x90-01

Leave a Reply

Your email address will not be published. Required fields are marked *