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April Update of CLIA-Waived Tests, Billing Codes

by | Feb 25, 2015 | CLIA-nir, CMS-nir, Essential, National Lab Reporter

The April 1, 2013, update to the list of tests waived under the Clinical Laboratory Improvement Amendments (CLIA) includes 24 more devices, the latest approved by the Food and Drug Administration for this category (see table). New waived tests are approved on a flow basis and are valid as soon as approved. When billing for the tests below, you must use the QW modifier. This enables your local Medicare contractor to recognize the code as waived. Prior to payment approval, claims are checked for waived testing certification. Your carrier or Medicare Administrative Contractor is not required to search its files to either retract payment or retroactively pay claims; however, it should adjust claims you bring to its attention. The April update, plus a complete list of CLIA-waived devices, can be found in Change Request 8146, at www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R2619CP.pdf. Associated Data

The April 1, 2013, update to the list of tests waived under the Clinical Laboratory Improvement Amendments (CLIA) includes 24 more devices, the latest approved by the Food and Drug Administration for this category (see table). New waived tests are approved on a flow basis and are valid as soon as approved. When billing for the tests below, you must use the QW modifier. This enables your local Medicare contractor to recognize the code as waived. Prior to payment approval, claims are checked for waived testing certification. Your carrier or Medicare Administrative Contractor is not required to search its files to either retract payment or retroactively pay claims; however, it should adjust claims you bring to its attention. The April update, plus a complete list of CLIA-waived devices, can be found in Change Request 8146, at www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R2619CP.pdf.

Associated Data

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