Billing Beat

(CLIA) New Waived Tests

May 13, 2020

The Current Procedural Terminology (CPT) codes for these new tests must have the modifier QW to be recognized as a waived test.

Note: The tests mentioned on the first page of the list attached to CR 11747 (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.

See https://www.cms.gov/files/document/r10048CP.pdf  SUMMARY OF CHANGES: This Change Request (CR) will inform contractors of new Clinical Laboratory Improvement Amendments of 1988 (CLIA) waived tests approved by the Food and Drug Administration. Since these tests are marketed immediately after approval, the Centers for Medicare & Medicaid Services (CMS) must notify its contractors of the new tests so that the contractors can accurately process claims. There are 69 newly added waived complexity tests. EFFECTIVE DATE: July 1, 2020

Source: https://www.cms.gov/files/document/mm11747.pdf

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