New Waived Tests Released for Mid-Quarter
- By admin aapc
- In CMS
- March 13, 2009
- Comments Off on New Waived Tests Released for Mid-Quarter
New waived tests approved by the Food and Drug Administration (FDA) under the Clinical Laboratory Improvement Amendments (CLIA) of 1988 go into effect April 1.
The Centers for Medicare & Medicaid Services (CMS) released Transmittal 1689, Change Request (CR) 6370, with attachment, on Feb. 27, to inform contractors of a Recurring Update Notification (RUN) of the latest waived tests. This RUN can be found in Chapter 16, Section 70.8 of the Internet Only Manual.
To be recognized as a waived test, some CLIA waived tests have unique HCPCS Level II procedure codes and some must have modifier QW CLIA waived test included with the HCPCS Level II code. Click here to download the HCPCS Level II codes list subject to CLIA.
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Point of care urine drug testing:
Many physicians are performing these tests under waived certificates to determine drug use prior to prescribing narcotics. Many devices have segments designed to detect individual drug classes by immunoassay . They then bill for 80101QW x each analyte. However, when urine is sent to a lab for additional testing of analytes not included on the POCT device , the lab uses the 80101 code. The issue is that various payors are requesting refunds from the physicians stating that there is duplicate billing for the same test. It appears that the carriers are not recognizing the QW modifier . Suggestion?