Wiki QW Modifier

[LADY_SETSUNA_CJ]

I work for a pediatrics office and we sometimes bill out lab test such as 87804(influenza A/B) we have never billed out a modifier QW on them and have been getting paid. Our administrator is now telling us to get paid we need to start billing out a QW modifier with them when we bill.

I am very confused... I'm a newer coder and don't have coding experience outside of school. I understand that the QW modifier means 'CLIA waived test' and have read up on it but everything I read seems to confuse me even more. I'm not sure why we are now need the QW modifier.

Can someone please help?

Cheryl, CPC-A

 

[lring]

QW modifier

87804 can be done 2 ways - in the office (there's the QW) or can be sent to an outside lab to perform (no QW). I pulled the CLIA waived list from Medicare CMS site. I know you're Peds and don't have Mcare - but this list helps you to know what needs a QW and what doesn't. This gives you the company who makes the test so you get the brand name too.

http://www.cms.gov/Transmittals/downloads/R1905CP.pdf

I hope this helps.

 

[lring]

P.s. Qw

scroll down for the list

and they may be telling you to bill the tests twice for A & B - check with your provider to see if 2 tests are being performed