modifer

is 81002 billed with a QW modifer? I am getting a Medicare rejection
thank you

Jun 8th, 2011 - nmaguire 2,606

re: modifer

It is a CLIA waived test but does not require a QW

Jun 8th, 2011 - RTINNEY 23

re: modifer

Even though this is a CLIA waived test it does not require the QW modifier.

Jun 8th, 2011 - nmaguire 2,606

re: modifer

No, there are some codes that are CLIA and do not require QW.
https://www.cms.gov/ContractorLearningResources/downloads/JA6906.pdf

Jun 8th, 2011 - nmaguire 2,606

re: modifer

Urinalysis is commonly performed for routine screening. Since Medicare does not pay for routine screening other than specific tests (e.g., mammograms, Pap smears), urinalysis cannot be covered unless it is performed for the evaluation of a patient's complaint or clinical signs. 81002 $3.57, check laboratory fee schedule for POS-office.

2011 Clinical Diagnostic Laboratory
Fee Schedule

81002 $3.60

Jun 8th, 2011 - nmaguire 2,606

re: modifer

https://www.cms.gov/ClinicalLabFeeSched/02_clinlab.asp

Jun 8th, 2011 - nmaguire 2,606

re: modifer

texas fee schedule Lab:
http://www.trailblazerhealth.com/Tools/Fee%20Schedule/ClinicalLabFeeSchedule.aspx

Jun 8th, 2011 - carmenette 1

re: modifer

thanks everyone for the response

Jun 8th, 2011 - agent00711 151

re: modifer

Medicare does not cover 81002 source http://www.trailblazerhealth.com/Tools/Fee%20Schedule/MedicareFeeSchedule.aspx