Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits

• Discontinued HCPCS codes • New HCPCS codes • Which HCPCS codes are subject to and excluded from Clinical Laboratory Improvement Amendments (CLIA) edits

The following HCPCS codes are excluded from CLIA edits (effective as noted) and don’t need the facility to have any CLIA certificate:

• 0254U – reimplantation genetic assessment of embryo by gene sequence analysis of 24 chromosomes for abnormal chromosome number – Effective July 1, 2021
• 0294U – Longevity and mortality risk, mrna, gene expression profiling by rna sequencing of 18 genes, whole blood, algorithm reported as predictive risk score – Effective January 1, 2022
• 80503 – Pathology clinical consultation for clinical problem, 5-20 minutes – Effective January 1, 2022
• 80504 – Pathology clinical consultation for moderately complex clinical problem, 21-40 minutes – Effective January 1, 2022
• 80505 – Pathology clinical consultation for complex clinical problem, 41-60 minutes – Effective January 1, 2022
• 80506 – Pathology clinical consultation, additional 30 minutes – Effective January 1, 2022

Source: https://www.cms.gov/files/document/mm12573-healthcare-common-procedure-coding-system-hcpcs-codes-subject-and-excluded-clinical.pdf