2009 HCPCS Codes Affected by CLIA Edits

The Centers for Medicare & Medicaid Services (CMS) has updated the list of HCPCS codes subject to or excluded from Clinical Laboratory Improvement Amendments (CLIA) edits for 2009.

New HCPCS codes subject to CLIA edits for 2009 that require a facility to have either a CLIA certificate of registration (certificate type code 9), a CLIA certificate of compliance (certificate type code 1), or a CLIA certificate of accreditation (certificate type code 3) are:

HCPCS Description

  • 83876 – Myleoperoxidase (MPO)
  • 83951 – Oncoprotein; des-gamma-carboxy-prothrombin (DCP)
  • 85397 – Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte
  • 87905 – Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid)

Note: This list does not include new HCPCS codes for waived tests or provider-performed procedures.

HCPCS codes excluded from CLIA edits in 2009 that do not require a facility to have a CLIA certificate are:

HCPCS Description

  • 88720 – Bilirubin, total trancutaneous
  • 88740 – Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin
  • 88741 – Hemoglobin, quantitative, transcutaneous, per day; methemoglobin

HCPCS codes discontinued as of Dec. 31, 2008 are:

HCPCS Description

  • G0394 – Blood occult test (eg, guaiac), feces for single determination for colorectal neoplasm (ie, patient was provided three cards or single triple card for consecutive collection)
  • 88400 – Bilirubin, total trancutaneous
  • 0026T – Lipoprotein, direct measurement, intermediate density lipoprotein (IDL) (remnant lipoproteins)
  • 0041T – Urinalysis infectious agent detection, semi-quantitative analysis of volatile compounds

CMS issued Transmittal 1687, Change Request (CR) 6356, Feb. 20, to inform all interested parties of these changes, which went into effect Jan. 1 and will be implemented April 6.

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One Response to “2009 HCPCS Codes Affected by CLIA Edits”

  1. Pat Karr says:

    G0394 is not longer the correct code for Guaiacs– what is the correct code to use now? thanks

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