Part B Insider (Multispecialty) Coding Alert

Physician Notes:

CMS Approves CLIA-Waived Status for 21 Lab Tests -- Just Remember to Use Modifier QW

Plus: Mass immunization season is upon us -- CMS outlines the facts you need to know to start reporting vaccinations

Effective Oct. 1, you'll have a host of lab codes that you'll be able to report as "CLIA-waived," thanks to a Sept. 12 CMS transmittal on the matter.

According to Transmittal 1594, CMS will now consider 21 additional tests CLIA-waived. You'll have to append modifier QW (CLIA-waived test) to these codes, which include the following, among others:

• 83520 -- Immunoassay, analyte, quantitative; not otherwise specified

• 87880 -- Infectious agent detection by immunoassay with direct optical observation; Streptococcus, group A

• 89300 -- Semen analysis; presence and/or motility of sperm including Huhner test (post coital)

To read the full list of newly-approved CLIA-waived tests, visit the CMS Web site at http://www.cms.hhs.gov/transmittals/downloads/R1594CP.pdf.

In other news ...

Providers who would like to brush up on vaccination billing procedures before the season starts can consult two new transmittals from the Centers for Medicare & Medicaid Services.

The agency outlines the difference between mass immunization roster billers and centralized billers, among other specifics, in Aug. 15 Transmittal No. 366 (CR 6121).

Reminder: Beneficiaries do not need to have a physician's order or supervision to receive a Medicare-covered vaccination, points out the transmittal, which you can find at http://www.cms.hhs.gov/transmittals/downloads/R366OTN.pdf. A related MLN Matters article is at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6121.pdf.

And CMS spells out vaccination billing changes to the Medicare Claims Processing Manual in a 56-page Sept. 5 transmittal.

For example: Roster bills do not require a National Provider Identifier (NPI), CMS says in Transmittal No. 1586 (CR 6079), located at http://www.cms.hhs.gov/transmittals/downloads/R1586CP.pdf.