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Does CPT 81003 need a QW modifier?

by Rhyley Bryan

Does CPT 81003 need a QW modifier?

Providers possessing a Clinical Laboratory Improvement Amendments (CLIA) Certificate of Wavier or Provider – Performed Microscopy Procedures (PPMP) must utilize a test kit and bill the program utilizing a QW modifier with for the following codes: 80061, 80101, 81003, 81007,82010, 82044, 82055, 82120, 82273, 82274.

What test is granted waived status under CLIA?

Waived tests include test systems cleared by the FDA for home use and those tests approved for waiver under the CLIA criteria. Although CLIA requires that waived tests must be simple and have a low risk for erroneous results, this does not mean that waived tests are completely error-proof.

What CPT codes are CLIA-waived?

Certain codes describe only CLIA-waived tests and therefore are exempt from the requirement to add the QW modifier. The CPT codes for the tests currently exempt from the requirement are 81002, 81025, 82270, 82272, 82962, 83026, 84830, 85013, and 85651.

What is a CLIA non waived test?

Nonwaived testing is the term used to refer collectively to moderate and high complexity testing. Laboratories or sites that perform these tests need to have a CLIA certificate, be inspected, and must meet the CLIA quality standards described in 42 CFR Subparts H, J, K and M.

Which lab tests are CLIA waived?

As defined by CLIA, waived tests are “simple laboratory examinations and procedures that have an insignificant risk of an erroneous result.” Examples of waived tests include: dipstick urinalysis, fecal occult blood, urine pregnancy tests, and blood glucose monitoring.

What is the CPT code 81003?

The Current Procedural Terminology (CPT) code 81003 as maintained by American Medical Association, is a medical procedural code under the range-Urinalysis Procedures.

What do you need to know about waived testing?

CLIA certification. Each site offering only waived testing that is not included under any other type of CLIA certificate must obtain a CLIA CW before testing patient specimens.

  • State and local regulations. States and local jurisdictions vary as to the extent to which they regulate laboratory testing.
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    • What is CLIA waived means?

    When a test is CLIA waived, it means that the test itself is so simple and accurate in itself that it is impossible to produce incorrect results in conducting them. A test can also be CLIA waived if it is proven that it does not do any harm to the human body. In addition, a test becomes automatically CLIA waived if…

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