Pathology/Lab Coding Alert

Don't miss new tests or new codes  for 2007 The current update for waived tests under the Clinical Laboratory Improvement Amendments (CLIA) includes not just newly approved tests but also existing waived tests that require new coding. Post these changes now so you don't miss out on payment for these services.

The update is effective Jan. 1, and you can access CMS change request 5404 at www.cms.hhs.gov/transmittals/downloads/R1115CP.pdf.

Use These Codes for Newly Approved Tests CLIA adds three new tests to the waived-status list:

- Immunostics Inc. hema-screen Specific Immunochemical Fecal Occult Blood Test.

Report this test as 82274-QW (Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations; CLIA-waived test) for diagnostic testing. For a screening test, report G0328-QW (Colorectal cancer screening; fecal-occult blood test, immunoassay, 1-3 simultaneous determinations).

- Gryphus Diagnostics BVBlue.

Report this test to help diagnose bacterial vaginosis as 87899-QW (Infectious agent detection by immunoassay with direct optical observation; not otherwise specified).

- ESA Biosciences LeadCare II Blood Lead Testing System (whole blood).

The correct code for this test is 83655-QW (Lead).

Update Codes for Existing CLIA-Waived Tests Based on new CPT and HCPCS codes, you should change how you report the following tests that you may already have been performing as CLIA-waived tests:

- Genzyme OSOM Trichomonas Rapid Test.

No longer report this test with 87899-QW; instead, use new code 87808-QW (Infectious agent antigen detection by immunoassay with direct optical observation; Trichomonas vaginalis)

- Screening Fecal Occult Blood Test (FOBT) with three specimens by peroxidase activity.

Stop using G0107 (Colorectal cancer screening; fecal-occult blood test, 1-3 simultaneous determinations), but instead use 82270 (Blood, occult, by peroxidase activity [e.g., guaiac], qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening [i.e., patient was provided three cards or single triple card for consecutive collection]). Modifier QW is not necessary to show waived status of 82270.