In Billing
Apr 26th, 2019
Clinical diagnostic laboratories submitting claims to Medicare should be aware of 12 new tests recently approved by the FDA. The new Clinical Laboratory Improvement Amendments of 1988 (CLIA) waived tests are shown in Table 1. Table 1: New Waived Tests Requiring QW Modifier (MLN Matters MM11231) CPT® Code Effective Date Description 80305QW September 14, 2018 ...
In CMS
Jan 3rd, 2019
Clinical Laboratory Improvement Amendments (CLIA) fees are being increased for the first time in 20 years, according to a holiday week notice from the Centers for Medicare & Medicaid Services (CMS). CLIA Fees Based on 1992 CMS wants a 20 percent increase for laboratories seeking a CLIA certificate. The agency explained that the program and ...
In Billing
May 11th, 2018
If you’re reporting presumptive drug tests using codes 80305-80307, the Centers for Medicare & Medicaid Services reminds medical coders and billers that you can use G0340-G0383 for Medicare coding. Drug Tests: Abused Drugs Coding for testing a patient for drugs commonly abused is based on a structure of screening, which is often referred to as presumptive testing, ...
Jul 1st, 2016
A final rule the Centers for Medicare & Medicaid Services (CMS) published in the Federal Register on June 27 requires entities performing clinical diagnostic laboratory tests to report private payer rates for lab tests. CMS will use this data to calculate Medicare rates for lab tests paid under the Clinical Laboratory Fee Schedule (CLFS) beginning ...
In Coding
Oct 15th, 2015
Modifier 91 Repeat clinical diagnostic laboratory test is used to report the same lab test when performed on the same patient, on the same day, to obtain subsequent test results. Modifier 91 causes a lot of confusion when differentiating its use from that of modifier 59 Distinct procedural service. When reporting lab procedures, modifier 59 ...