Change Request (CR) 6985, informs A/B MACs or carriers about additional new Healthcare Common Procedure Coding System (HCPCS) codes for 2010 that are subject to Clinical Laboratory Improvement Amendments (CLIA) edits.
The HCPCS codes listed in the table, below, are new for 2009 and subject to CLIA edits, and require a facility to have either:
- A CLIA certificate of registration (certificate type code 9);
- A CLIA certificate of compliance (certificate type code 1); or
- A CLIA certificate of accreditation (certificate type code 3).
A facility without a valid, current, CLIA certificate, with a current CLIA certificate of waiver (certificate type code 2) or a current CLIA certificate for provider-performed microscopy procedures (certificate type code 4) cannot be paid for these tests.
HCPCS |
Modifier |
Description |
G0416 |
Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 1-20 specimens |
|
G0416 |
TC |
Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 1-20 specimens |
G0416 |
26 |
Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 1-20 specimens |
G0417 |
Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 21-40 specimens |
|
G0417 |
TC |
Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 21-40 specimens |
G0417 |
26 |
Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 21-40 specimens |
G0418 |
Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 41-60 specimens |
|
G0418 |
TC |
Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 41-60 specimens |
G0418 |
26 |
Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 41-60 specimens |
G0419 |
Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, greater than 60 specimens |
|
G0419 |
TC |
Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, greater than 60 specimens |
G0419 |
26 |
Surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, greater than 60 specimens |
