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Medicare procedure code and modifier ?

TiffanyNH

Networker
Messages
54
Best answers
0
Hello I have a question for everyone, we have a code 87081 which is a rapid strep test. We have billed it by it's self and with a modifier QW both get denied. Does anyone know if this code will payout? And if so how do you bill it? Txs for the help!!!:)
 

RebeccaWoodward*

True Blue
Messages
3,126
Location
North Carolina
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0
Typically, the rapid strep test is 87880...

Code 87880 (direct observation) should be used for all immunologically-based commercial Streptococcus Group A testing kits whose interpretation rely on a visual reaction (observed by the naked eye)
 

TiffanyNH

Networker
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54
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0
TXS!!! I really appreaciate it!! Thats what the issue was right modifier, they had the wrong code!!! U guys ROCK!! Tiffany
 

thythaot

Guest
Messages
20
Location
Portland, Oregon
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0
modifier QW

Hi,

I am knowing that modifier is use for waiwed CLIA test, and 87081 is not on a waived CLIA test. So if you want to bill 87081, you should not use QW modifier. Other way, if you use modifier QW, you must have the correct CLIA number on the claim to be bill.
This is the sample of some laboratory and pathology that show on Medical Services Aministration (MSA)
Waived CLIA Test Codes: 81002, 81003QW, 81025, 82465QW, 82947QW, 84703QW, 85013,
85014QW, and 85018QW
Physician Performed Microscopy Procedure Codes: 81000, 81001, and 81015
CLIA Certificate of Compliance/Accreditation Codes: 82948, 85660, 87077, 87081, 87205, 87207,
87210 and 87270.
NOTE: Modifier QW designates the procedure as a waived CLIA test.

Good luck ;)
Jeslyn CPC-A
 
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