Tuesday, April 19, 2011

Clinical Laboratory Fee Schedule - Update

Clinical Laboratory Fee Schedule – Removal of Test Code G0431QW and Addition of Test Code G0434QW

CMS is updating the status of the following two codes on the Clinical Laboratory Fee Schedule (CLFS), effective April 1, 2011:
  • HCPCS code G0431QW is deleted from the CLFS. HCPCS code G0431 describes a high-complexity test and should not be reported with a QW modifier (QW modifier indicates a Clinical Laboratory Improvement Amendments of 1998 (CLIA)-waived test).
  • HCPCS code G0434QW is added to the CLFS. HCPCS code G0434 can describe a CLIA waived test. The use of the QW modifier to indicate a CLIA-waived test is necessary for accurate claims processing.
  • HCPCS codes G0431 and G0434 will remain on the CLFS.