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January Update of CLIA-Waived Tests, Billing Codes

by | Feb 25, 2015 | CLIA-nir, CMS-nir, Essential, National Lab Reporter

The Jan. 1, 2013, update to the list of tests waived under the Clinical Laboratory Improvement Amendments (CLIA) includes 36 more devices, the latest approved by the Food and Drug Administration for this category (see table). New waived tests are approved on a flow basis and are valid as soon as approved. When billing for the tests below, you must use the QW modifier. This enables your local Medicare contractor to recognize the code as waived. Prior to payment approval, claims are checked for waived testing certification. CPT CODE EFFECTIVE DATE DECRIPTION 86803QW Nov. 29, 2011 OraQuick HCV Rapid Antibody Test and OraQuick Visual Reference Panel 87809QW April 24, 2012 AdenoPlus (human eye fluid) 81003QW May 8, 2012 McKesson 120 Urine Analyzer 81003QW May 11, 2012 Acon Laboratories, Inc. Foresight U120 Urine Analyzer 86294QW May 15, 2012 LifeSign Status BTA 82055QW May 25, 2012 Alere Toxicology Services, iScreen Saliva Alcohol Test Strip 82055QW May 25, 2012 American Screening Corporation, Reveal Saliva Alcohol Test Strip G0434QW May 29, 2012 BTNX Inc Rapid Response X-Press Drug Test Cassette G0434QW May 29, 2012 BTNX Inc Rapid Response X-Press Drug Test Cassette Amp/Amphetamine G0434QW May 29, 2012 BTNX Inc Rapid Response X-Press Drug Test […]

The Jan. 1, 2013, update to the list of tests waived under the Clinical Laboratory Improvement Amendments (CLIA) includes 36 more devices, the latest approved by the Food and Drug Administration for this category (see table). New waived tests are approved on a flow basis and are valid as soon as approved. When billing for the tests below, you must use the QW modifier. This enables your local Medicare contractor to recognize the code as waived. Prior to payment approval, claims are checked for waived testing certification.
CPT CODEEFFECTIVE DATE DECRIPTION
86803QWNov. 29, 2011OraQuick HCV Rapid Antibody Test and OraQuick Visual Reference Panel
87809QWApril 24, 2012AdenoPlus (human eye fluid)
81003QWMay 8, 2012McKesson 120 Urine Analyzer
81003QWMay 11, 2012Acon Laboratories, Inc. Foresight U120 Urine Analyzer
86294QWMay 15, 2012LifeSign Status BTA
82055QWMay 25, 2012Alere Toxicology Services, iScreen Saliva Alcohol Test Strip
82055QWMay 25, 2012American Screening Corporation, Reveal Saliva Alcohol Test Strip
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test Cassette
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test Cassette Amp/Amphetamine
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test Secobarbital Cassette
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test Oxazepam Cassette
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test Strip
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test Strip Amp/Amphetamine
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test Secobarbital Strip
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test Oxazepam Strip
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test (COC/Cocaine){Cup format}
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test (MET/Methamphetamine){Cup format}
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test (MDMA/ Methylenedioxymethamphetamine) {Cup format}
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test (MOP/Morphine){Cup format}
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test (MTD/Methadone){Cup format}
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test Morphine (2000){Cup format}
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test (PCP/Phencyclidine){Cup format}
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test Notriptyline{Cup format}
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test (COC/Cocaine){Dip card format}
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test (MET/Methamphetamine){Dip card format}
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test (MDMA/ Methylenedioxymethamphetamine) {Dip card format}
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test (MOP/Morphine){Dip card format}
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test (MTD/Methadone){Dip card format}
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test Morphine (2000){Dip card format}
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test (PCP/Phencyclidine){Dip card format}
G0434QWMay 29, 2012BTNX Inc Rapid Response X-Press Drug Test Notriptyline{Dip card format}
83036QWMay 30, 2012Bayer AICNow+ Professional Use
87880QWJune 7, 2012Mooremedical Strep A Rapid Test—Dipstick
G0434QWJuly 13, 2012Ultimate Analysis Cup UA Cups
86701QWJuly 20, 2012bioLytical INSTI HIV-1 Antibody Test {Fingerstick Whole Blood}
G0433QWJuly 20, 2012OraSure Technologies OraQuick In-Home HIV Test {Oral Fluid}
  The update, plus a complete list of CLIA waived devices, can be found in Change Request 8054, at www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R2553CP.pdf. Your carrier or Medicare Administrative Contractor is not required to search its files to either retract payment or retroactively pay claims; however, it should adjust claims you bring to its attention.

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