New HCPCS Codes Subject To or Excluded From CLIA Edits

New HCPCS Codes Subject To or Excluded From CLIA Edits

The Centers for Medicare & Medicaid Services (CMS) released a provider education article (MLN Matters® MM9035), January 30, to inform physicians and their support staff of retroactive changes to HCPCS Level II codes subject to, or excluded from, Clinical Laboratory Improvement Amendments (CLIA) edits.

Codes discontinued on December 31, 2014 are:

G0417-G0419, 80100-80104, 80152, 80154, 80160, 80166, 80172, 80174, 80182, 80196, 80440, 82000, 82003, 82055, 82101, 82145, 82205, 82520, 82646, 82649, 82651, 82654, 82666, 82690, 82742, 82953, 82975, 82980, 83008, 83055, 83071, 83634, 83805, 83840, 83858, 83866, 83887, 83925, 84022, 84127, 87001, 87620, 87621-87622, 88343, 88349

New codes subject to CLIA edits are:

G0464, G6030-G6058, 80163, 80165, 80300-80304, 80320-80377, 81246, 81288, 81313, 81410-81411, 81415-81417, 81420, 81425-81427, 81430-81431, 81435-81436, 81440, 81445, 81450, 81455, 81460, 81465, 81470-91471, 81519, 87505-87507, 83006, 87623-87625, 87806, 88341, 88344, 88364, 88366, 88369, 88373-88374, 88377

Excluded from CLIA edits is new code 89337 Cryopreservation, mature oocyte(s). This service was previously reported with Category III CPT® code 0059T, which is now deleted.

These changes are retroactively effective January 1, 2015. Medicare administrative contractors have until April 6, 2015 to implement these changes.

CMS also reminds providers in MM9035 that HCPCS Level II G0472 Hepatitis C antibody screening, for individual at high risk and other covered indication(s) is covered for services performed on or after June 2, 2014. This code is subject to CLIA edits.

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Renee Dustman

Renee Dustman

Renee Dustman is executive editor at AAPC. She has a Bachelor of Science degree in Journalism and a long history of writing just about anything for just about every kind of publication there is or ever has been. She’s also worked in production management for print media, and continues to dabble in graphic design.
Renee Dustman

About Has 423 Posts

Renee Dustman is executive editor at AAPC. She has a Bachelor of Science degree in Journalism and a long history of writing just about anything for just about every kind of publication there is or ever has been. She’s also worked in production management for print media, and continues to dabble in graphic design.

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