BILLING NEWS

CLIA-Waived Tests Modifier Reminder

Providers are reminded that effective retroactively for dates of service on or after October 1, 2005, the following CPT-4 codes may be billed with modifier QW (CLIA-waived tests):

CPT-4 Code Description
84443 Thyroid stimulating hormone (TSH)
84450 Transferase; aspartate amino (AST) (SGOT)
85576 Platelet, aggregation (in vitro), each agent
86703 HIV-1 and HIV-2, single assay

Modifier QW indicates that the provider certifies that a specific test kit from manufacturers identified by the Centers for Medicare & Medicaid Services (CMS) was used when performing the test. All claims billed with modifier QW that were denied due to the provider not being certified for the laboratory procedure billed will be automatically reprocessed.


SOURCE: Source
INDUSTRY NEWS TAGS: California Medi-Cal


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