New approved waived test by CMS

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HCPCS code G0477 was discontinued on 12/31/2016 and the new HCPCS code 80305 was effective by 01/01/2017. HCPCS code 80305QW indicates the waived testing, previously being assigned HCPCS code G0477QW. CPT code 80305 was approved by the FDA as a waived test under CLIA and must be billed with the modifier QW.

The new waived complexity code 87633QW, was assigned for the testing performed by BioFire Diagnostics, FilmArray 2.0 EZ Configuration Instrument which relates to Viral as well as Bacterial Nucleic Acids, and Nasopharyngeal Swabs.

CMS MLN Matters MM9946 indicates that CLIA Services are reimbursed for only those providers who are falling under 9, 1, or 3 CLIA Certificate Type Code other than these it will be denied.

The 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 as mentioned on the first page of the list attached to CMS CR9956.

For more details you can be refer CMS MLN Matters MM9956.

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