Wiki Clia 81003

[hbarney1]

So I received a denial for an ER pt on CPT code 81003 which had a (XU mod appended), saying that the modifier appended got denied. I looked online and per CLIA instead of mod XU I can put mod QW? It is a simplified test and the test is CLIA approved.

http://www.tmhp.com/News_Items/2017... for Some CLIA Waived Lab PCs, Eff 1-1-18.pdf

 

[mitchellde]

why was the XU modifier appended in the first place? if it was coded by you then you should know why it was chosen, and was that a valid reason, if it was coded by a different coder then you should ask that coder why it was chosen. If it is CLIA waved then yes a QW modifier is needed.
You should always know the reason you are appending a modifier and be prepared to express why you chose it. If your logic is flawed then it can be corrected.