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Pulmonary Rehabilitation (PR) Services
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Maximum Period for Submission of Medicare Claims Reduced to Not More Than 12 Months
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Appeals Revisions AIC Requirements
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Date Issued:
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02-05-2010
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Implementation Date:
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04-05-2010
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Effective Date:
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04-05-2010
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Source:
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CMS - Transmittal
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Source#:
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CR6812
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Category:
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Edits Lab
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CBSI Contact:
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Missy Tieken
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The Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations require a facility to be appropriately certified for each test performed. To ensure that Medicare & Medicaid only pay for laboratory tests categorized as waived complexity under CLIA in facilities with a CLIA certificate of waiver, laboratory claims are currently edited at the CLIA certificate level.
Listed below are the latest tests approved by the Food and Drug Administration as waived tests under CLIA. The Current Procedural Terminology (CPT) codes for the following new tests must have the modifier QW to be recognized as a waived test. However, the tests mentioned on the first page of the attached list (i.e., CPT codes: 81002, 81025, 82270, 82272, 82962, 83026, 84830, 85013, and 85651) do not require a QW modifier to be recognized as a waived test.
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http://www.cms.gov/transmittals/downloads/R1905CP.pdf
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