New Waived Tests Payable Under Medicare
- By admin aapc
- In AAPC News
- April 12, 2012
- Comments Off on New Waived Tests Payable Under Medicare
Certified facilities performing laboratory tests should be aware of a recent update to the list of codes subject to or excluded from Clinical Laboratory Improvement Amendments (CLIA) edits.
New codes subject to CLIA edits and payable under Medicare are shown in the table below.
| Code | Effective date | Description |
| G0434QW | April 22, 2011 | Diagnostic test group clarity multiple drug screen cups |
| 87804QW | Dec. 9, 2011 | BD Veritor System for rapid detection of flu A+B (For use with nasal and nasopharyngeal swabs) {includes a reader} |
| G0434QW | Dec. 14, 2011 | Alere Toxicology Services Alere iCassette DX Drug Screen |
| 82055QW | Jan. 6, 2012 | Jant Pharmacal Corporation Accustrip Saliva Alcohol Test Strip |
| 83861QW | Jan. 23, 2012 | TearLab Corporation TearLab Osmolarity System |
| G0434QW | Jan. 26, 2012 | Alere iCassette drug screen |
| 87804QW | Jan. 27, 2012 | Alere influenza A & B test (for use with nasal swabs only) |
| 87808QW | Feb. 3, 2012 | Sekisui Diagnostics, LLC OSOM Trichomonas Rapid Test |
| 87880QW | March 1, 2012 | Sekisui Diagnostics, LLC OSOM Strep A Test {direct from throat swab} |
| 86386QW | Jan. 1, 2012 | Nuclear matrix protein 22 (NMP22), qualitative |
| 87389QW | Jan. 1, 2012 | Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies, single result |
| 0279T | Jan. 1, 2012 | Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); |
| 0280T | Jan. 1, 2012 | Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); interpretation and report |
CPT® 2012 added 101 new codes for molecular pathology (81200-81408) that are subject to CLIA edits; however, these codes are not payable under Medicare.
Effective Jan. 1, 2012, CPT® codes 88107 Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears and filter preparation with interpretation and 88318 Determinative histochemistry to identify chemical components (e.g., copper, zinc) have been discontinued. (To report smears and simple filter preparation, see 88104 Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation or 88106 Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation. For determinative histochemistry to identify chemical components, use 88313 Group II, all other (e.g., iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunoperoxidase.)
The Centers for Medicare & Medicaid Services (CMS) notified contractors of these changes on April 6, in Transmittal 2441. Contractors are to implement these changes by July 2, 2012. Contractors are not required to search their files to either retract or pay claims already submitted, but are instructed by CMS to adjust claims brought to their attention.
For more information, see CMS Transmittal 2439 and MLN Matters® articles MM7795, MM7766.
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