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Thread: G0434-qw

  1. #1
    Join Date
    Apr 2007
    Denver Colorado

    Default G0434-qw

    AAPC: Back to School
    Medicare has released a transmittal on February 11th that is effective for 2011 dates of service. It directs contractors to accept G0434-QW in the place of G0430-QW...

    "The Medicare contractor shall permit the use of code G0434QW for claims submitted by facilities with a valid, current CLIA certificate of waiver with dates of service on or after January 1, 2011."

    For any of you that received denials from your Medicare contractors for invalid modifier with G0434-QW, reference this transmittal for your appeals: http://www.cms.gov/transmittals/downloads/R2155CP.pdf

    For any of your practices that are CLIA-waived, it will be necessary to continue to use the QW modifier with G0434 to indicate that you are compliantly using a CLIA waived test method.

  2. #2

    Question G0434 unit charge

    Need some feedback about unit charging for this code; previously charged per test [i.e., twelve drugs tested, $$ x 12]. Is that still acceptable?

  3. #3
    Join Date
    Apr 2007


    MLN Matters® Number: SE1105

    "Only one unit of service for code G0434 can be billed per patient encounter regardless of the number of drug classes tested and irrespective of the use or presence of the QW modifier on claim lines."

    "CMS introduced code G0434 to report qualitative point-of-care drug screen testing and to limit billing for such testing to one time per patient encounter."

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