tci Outpatient Facility Coding Alert - 2015 Issue 1

Reader's Question: CLIA Does Not Include 83009 and 86677

Question: Do we need to append modifier QW to 83009 and 86677 when they are done in the provider facility? New Jersey Subscriber Answer: 83009 (Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope [e.g., C-13]) and 86677 (Antibody; Helicobacter pylori) are not included on the Clinical Laboratory Improvement Amendments (CLIA) waved list. The CLIA affects all laboratories and any practice that has an in-office lab however, small. CLIA establishes three categories of lab tests: waived, moderate complexity, and high complexity. Small, in-office labs commonly have a certificate of waiver that allows them to perform and bill...

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