MM11916 – New Waived Tests

The Current Procedural Terminology (CPT) codes for these new tests must have the modifier QW to be recognized as a waived test. However, the tests mentioned on the first page of the list attached to CR 11916 (such as 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.

The CPT code, effective date and description for the latest tests approved by the FDA as waived tests under CLIA are the following:

• 87880QW, November 26, 2019, Dealmed Medical Supplies LLC, Strep A Rapid Test Kit

• 82465QW, February 26, 2020, Germaine Laboratories Inc. AimStrip Tandem Lipid Profile and Glucose Measuring System (Germaine Laboratories Inc. AimStrip Tandem Total Cholesterol Test Strips)

 • 84478QW, February 26, 2020, Germaine Laboratories Inc. AimStrip Tandem Lipid Profile and Glucose Measuring System (Germaine Laboratories Inc. AimStrip Tandem Triglycerides Test Strips)

• 86308QW, March 5, 2020, Sekisui Diagnostics, LLC. OSOM Mono Test {Whole blood}

• 87804QW, April 3, 2020, Sekisui Diagnostics, LLC, OSOM Ultra Plus Flu A&B Test {Nasal and Nasopharyngeal Swabs}

Note: MACs will not search their files to either retract payment or retroactively pay claims. However, MACs should adjust claims if you bring those claims to their attention.

Source: https://www.cms.gov/files/document/r10230CP.pdf