re: Medicare denying CPT® 82948 We are a clia waived office and use "82962". (The code 82948 is classified as a moderately complex test and therefore would be denied if you only have a PPM (provider-performed microscopy) certificate as you have stated.
Does Medicare cover CPT 82948?
Medicare replacement (PDF download) medicare benefits (PDF download) medicare part b (PDF download) is cpt code 82948 clia waived. PDF download: Tests Subject to CLIA Edits – CMS. 2017 CPT-4 and HCPCS Codes Subject to CLIA Edits. Includes non-waived and. non-PPMP tests.
What does CLIA waived testing mean?
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.
What does CPT code 82947 mean?
What does CPT code 82947 mean? 82947 Glucose; quantitative, blood (except reagent strip) 82948 Glucose; blood, reagent strip 82962 Glucose, blood by glucose monitoring device cleared by FDA for home use.
What is an example of a CLIA waived test?
What tests are considered CLIA waived?
- Employ methodologies that are so simple and accurate as to render the likelihood of erroneous results negligible.
- Use unprocessed specimens (whole blood or oral fluid)
- Pose no reasonable risk of harm to the patient if the test is performed incorrectly.
- Are cleared by the FDA for home use.
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 does CPT code 82948 mean?
Blood Glucose TestingCPT Code: 82948 Blood Glucose Testing.
What modifier is to be used with 82948?
Modifier 91: Repeat clinical diagnostic laboratory tests. This modifier is added only when additional test results are medically necessary on the same day. Example: Laboratory submits Medicare claim for four glucose; blood, reagent strip tests (CPT® code 82948).
What is the difference between 82948 and 82962?
82962 is column one code, 82948 is column two code and a one is in the modifier column. Now, having listed this, I don't really see a reason to do both tests simultaneously, so I wouldn't report both. Unless your Dr can give you a medically necessary reason to do both tests I wouldn't.
Is 82948 covered by Medicare?
CPT codes 82947 and 82948 are excluded from Duplicate Laboratory Services. Only one laboratory provider will be reimbursed when multiple individuals report Duplicate Laboratory Services.
What CPT codes require 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, ...
Is 81000 a CLIA waived test?
Two codes you won't find on the CLIA-waived tests list are 81000 and 81001. Instead of being CLIA-waived, these codes are on the Provider-Performed Microscopy Procedure (PPMP) list because both require microscopic evaluation of the urine specimen, says Avery.
Is 0241U a CLIA waived test?
The HCPCS codes 0240U, 0241U and 87637 describe the testing you perform with this EUA. When the FDA authorizes tests for use at the point of care (including SARS-CoV-2 point of care test systems) under an EUA, such tests are deemed to be CLIA waived tests.
Is 87880 a CLIA waived test?
The laboratory codes must be reported with modifier -QW to be recognized as a CLIA waived test. 87880-QW, infectious agent antigen detection by immunoassay with direct optical observation; streptococcus, group A. Effective November 26, 2019.
What is the CPT code for glucose finger stick?
Synonyms:LIS Mnemonic:FSGLUDepartment:CHEMISTRYContainer:Finger StickTransport:CPT-4:829621 more row
Does Medicare pay for 82962?
Code 82962 is defined in the 2004 HCPCS as a test for “glucose, blood by glucose monitoring device cleared by the FDA specifically for home use.” The Medicare carrier denied coverage of the blood glucose testing claimed under HCPCS code 82962 because the testing “is considered part of routine personal care and is not a ...
What is the CPT code for a glucose test?
Depending on the method employed, providers should use the following three CPT codes to report glucose testing: 82947 Glucose; quantitative, blood (except reagent strip) 82948 Glucose; blood, reagent strip. 82962 Glucose; blood by glucose monitoring device(s) cleared by the FDA specifically for home use.