Laboratory Procedure Code G0328 Now Requires Modifier QW

Effective April 1, 2011, for dates of service on or after October 1, 2010, colorectal cancer screening procedure code G0328 requires modifier QW for reimbursement. This change maintains compliance with Clinical Laboratory Improvement Amendments (CLIA) guidelines. Some claims for procedure code G0328 that were submitted without modifier QW with dates of service from October 1, 2010, through March 31, 2011, may have been paid in error. When these claims are reprocessed, any payments that were made in error may be deducted from future payments (i.e., recouped). Deductions will be reflected on Remittance and Status (R&S) Reports. No action on the part of the provider is necessary.