New CLIA-waived Tests Effective April 2019
- By Brad Ericson
- In Billing
- January 30, 2019
- 3 Comments
There are 13 new CLIA-waived tests effective April 1, 2019. The Center for Medicare & Medicaid Services (CMS) announced in CR11080 that these apply to facilities with a CLIA certificate of waiver.
QW is Key to CLIA Waived Test Codes
The modifier QW CLIA waived test must be appended to all but a handful of CPT codes to be recognized as a waived test. Codes not requiring the QW are 81002, 82270, 82272, 82962, 83026, 84830, 85013, and 85651 .
The new tests are:
- 80305-QW American Screening Corporation, Inc., Precision DX Quick Cup M300
- 80305-QW American Screening Corporation, Inc., Precision DX Quick Cup M2000
- 86618-QW Quidel Sofia 2 {Fingerstick whole blood}
- 80305-QW McKesson Medical-Surgical, Mckesson Drugs of abuse PPX Test Cup
- 80305-QW Jant Pharmacal Corp. Accutest VALUPAK Drug Screen Cup
- 80305-QW McKesson Medical-Surgical Inc. McKesson Multi Panel Drugs of abuse Test Cup
- 83036-QW Alere Technologies AS, AS100 Analyzer
- 83036-QW Alere Technologies AS, Afinion 2 Analyzer
- 80305-QW American Screening LLC, Precision Plus Quick Cup Tests
- 80305-QW American Screening LLC, Precision DX Quick Cup Tests
- 87804-QW Polymedco Inc., Poly stat Flu A&B {for use with nasal and nasopharyngeal swabs}
- 87634-QW Mesa Biotech Accula (Accula RSV Test)
All the waived tests can be found in CR 11080.
Brad Ericson
Director of Publishing at AAPC
Brad Ericson, MPC, CPC, COSC, is a seasoned healthcare writer and editor.He directed publishing at AAPC for nearly 12 years and worked at Ingenix for 13 years and Aetna Health Plans prior to that. He has been writing and publishing about healthcare since 1979. He received his Bachelor's in Journalism from Idaho State University and his Master's of Professional Communication degree from Westminster College of Salt Lake City.
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Hi,
Is modifier QW for Medicare claims only?
We have has several Humana claims denying our lab codes due to not having the CLIA or QW modifier on the lab codes. Do commercial plans require this now or is it just for Medicare claims only. Humana is the only payer we have had deny so far and this started around 1/1/19. Any guidance is appreciated!
All Medicare Advantage plans go by Medicare billing guidelines. Im assuming your Humana denials are coming from Humana Medicare plans. Bill them exactly as you would Medicare.