Wiki COVID TEST MODIFIER QUESTION

[kbarry59]

We are having some trouble finding the right way to be coding for covid tests out of our doctor’s office.

Do codes 87426 & 87635 need a QW modifier?

87635 is done in office but is being sent to a lab for results, does the office bill for that or the laboratory does?

87426 is being completed in office, is it ok to bill for it?

 

[gchmelewski]

HI, you would bill for the labs that you are doing in office and not bill for the ones you are sending off. 87426 does need qw and you should append your clia # to the code. we do not have qw on 87635. The one we don't bill for is the swab in nose and its sent out. the pcr test we do bill.

 

[kbarry59]

HI, you would bill for the labs that you are doing in office and not bill for the ones you are sending off. 87426 does need qw and you should append your clia # to the code. we do not have qw on 87635. The one we don't bill for is the swab in nose and its sent out. the pcr test we do bill.

Thank you very much

 

[Debra Lewis]

How do you append the Clia # to the code? We are using 87811QW. Some payers pay others do not so I thought I would try the Clia #? Thank You!

 

[Monashah]

Hi, we were sending 87811 with 59 and qw, and for Clia id double click the code from the claim then 1 window will appear hit additional information and there you will see Clia id spot you can put that number there and its done

 

[SHobbs]

I am so confused right now... Maybe someone could help. I am trying to help this provider, they are billing 87635 and when I questioned if they performed the test in house they said "this was not an inhouse covid test. It was a nasopharyngeal swab PCR test. I am billing for the collection" This is being sent out to a lab for testing....??