Health Information Management

CMS releases latest round of CLIA updates

APCs Insider, November 8, 2013

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CMS has released its update of the latest tests approved by the FDA as waived tests under the Clinical Laboratory Improvement Amendment (CLIA).

In order to receive payment from Medicare for laboratory tests, providers must have a current CLIA certificate. Each year, CMS updates which CPT® codes are subject to CLIA edits from approved facilities.

Coders must append modifier -QW to the CPT/HCPCS codes for the following new tests to denote a waived test. The CPT code, effective date and description for the latest tests approved by the FDA as waived tests under CLIA are the following:

• G0434-QW, January 23, 2008, Phamatech At Home 12 Drug Test (Model 9308T)

• G0434-QW, January 23, 2008, Phamatech At Home 12 Drug Test (Model 9308Z)

• 81003-QW, January 29, 2013, Henry Schein Urispec Plus Urine Analyzer
• G0434-QW, February 27, 2013, CLIAwaived, Inc., Rapid Drug Test Cup

• G0434-QW, February 27, 2013, Clinical Reference Laboratory, Inc., Intelligent Transport Cup

• G0434-QW, February 27, 2013, Noble Medical, Inc., Noble 1 Step Cup

• G0434-QW, February 27, 2013, Premier Integrity Solutions P/Tox Drug Screen Cup

• G0434-QW, February 27, 2013, US Diagnostics ProScreen Drugs of Abuse Cup

• 84443-QW, March 5, 2013, BTNX Rapid Response Thyroid Stimulating Hormone (TSH) Test

Cassette (Whole Blood)
• 86308-QW, March 11, 2013, Henry Schein OneStep Pro+ Mono {Whole Blood}

• G0434-QW, May 15, 2013, UCP Biosciences, Inc., UCP Home Drug Screening Test Cups

• G0434-QW, May 17, 2013, Alere Toxicology Services, Inc., Tox Screen Drugs of Abuse Test

Cup
• G0434-QW, June 24, 2013, Advin Multi-Drug Screen Test
• 87880-QW, July 3, 2013, Henry Schein OneStep Pro+ Strep A Cassette

Coders do not need to append modifier –QW to tests mentioned on the first page of the list attached to CR8439 (e.g., CPT codes: 81002, 81025, 82270, 82272, 82962, 83026, 84830, 85013, and 85651) do not require a -QW modifier to be recognized as a waived test.

For more information on the latest waived codes, see Transmittal 2804. To learn more about CLIA certification, visit CMS' website.



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