CMS Releases New CLIA-Waived Tests, Billing Codes

CMS notified contractors of new CLIA-waived tests effective January 1, 2015. There are 25 newly waived complexity tests, the latest approved by the FDA. The tests, listed in the table below, all require the QW modifier be attached to the CPT code for recognition as a waived test. CMS’s Transmittal indicates that contractors don’t have to go back to “retract payment or retroactively pay claims” but must adjust claims accordingly when brought to their attention. The following table provides a listing of the new CLIA-waived tests with their CPT Code, effective date and description. CPT CODE EFFECTIVE DATE DESCRIPTION 87807QW Mar. 18, 2014 BD Veritor System for Rapid Detection of RSV (For use with nasopharyngeal specimens) (Includes reader) G0434QW May 12, 2014 Native Diagnostics International, DrugSmart Dip Single/Multi-Panel Drug Screen Dip Card Test 87807QW May 30, 2014 Sofia RSV G0434QW June 9, 2014 Healgen THC One Step Marijuana Test Strip G0434QW June 9, 2014 Healgen THC One Step Marijuana Test Cassette G0434QW June 9, 2014 Healgen THC One Step Marijuana Test Cup G0434QW June 9, 2014 Healgen THC One Step Marijuana Test Dip Card G0434QW June 9, 2014 Healgen mAMP One Step Methamphetamine Test Strip G0434QW June 9, 2014 Healgen […]