Wiki Can 80354 be billed with a QW modifier and pay?

[allison.n.elliott14@gmail.com]

Colorado Medicaid is denying 80354 stating there is no billing rule for the procedure? What does this mean? I have found that 80307 cannot be billed with the QW modifier so I was wondering if this was the same case, however the denial reasons are different. 80307 states the provider needs a CLIA and there is information that the CLIA cannot be waived. 80354 I cannot find any information on and why it won't pay.

Thank you so much!
Nikki

 

[CBLENNIE]

According to the Colorado Department of Health Care Billing Manuals Laboratory Services Billing Manual the following information is listed in the section titled Drug Testing Unit Limitations and Documentation Requirements.

It appears that 80354 is no longer billable to Colorado's Medicaid program as of 07/31/2021.