Pathology News

CMS Drastically Cuts BRCA Testing Reimbursement Rate

  January 28, 2014 – CMS has drastically cut the reimbursement rate for BRCA testing services beginning January 1, 2014.  Medicare will pay a maximum of $1,440 to test for mutations in the BRCA1 and BRCA2 genes, a 49% reduction from the $2,795 reimbursement rate paid in 2013,   The cut was a result of […]

Tags: Medical Billing, Pathology Billing & Coding


MA – TUFTS HEALTH – Urine Drug Testing Policy

  11/19/2013 – For service dates January 1, 2014 and after, Tufts Health Plan will cover urine drug testing only when billed with the following codes: G0431 – Drug Screen, qualitative; multiple drug classes by high-complexity test method (e.g., immunoassay, enzyme assay), per patient encounter G0434 – Drug Screen, other than chromatographic; any number of […]

Tags: Medical Billing, Pathology Billing & Coding


NJ – HORIZON BCBS – Referrals to Participating Clinical Labs

  10/18/2013 –  All Horizon BCBS participating providers may only send testing samples to participating clinical laboratories. Laboratory Corporation of America Holdings (LabCorp) (which includes DIANON, Esoterix and US LABS) is the only in-network clinical laboratory services provider  for Horizon BCBSNJ managed care patients and a preferred provider for Horizon PPO and Indemnity patients.  It is also the exclusive provider […]

Tags: Pathology Billing & Coding


UNITED HEALTHCARE & HARVARD PILGRIM (MA) – New Drug Screen Testing Policy

  9/16/2013 – To align with the Centers for Medicare and Medicaid Services (CMS) guidance related to qualitative drug screen testing codes, UnitedHealthcare (effective first quarter of 2014) and Harvard Pilgrim Health Care (effective November 1, 2013)  will no longer reimburse qualitative drug screen testing for the following CPT codes: 80100—Drug screen, qualitative; multiple drug classes chromatographic method, each procedure […]

Tags: Pathology Billing & Coding


NY – EMPIRE BCBS – Molecular Code Policy Update

  August 19, 2013 – Empire BCBS has updated their reimbursement policy to include physician interpretation and report of molecular pathology procedure results as a bundled service and not eligible for reimbursement with dates of service on or after November 1, 2013.    

Tags: Pathology Billing & Coding


CT – ANTHEM BCBS – Updates Molecular Code Policy

  August 19, 2013 – On August 1, 2013, Anthem BCBS updated their Anthem Online Provider Services (AOPS) website with the policy to include physician interpretation and report of molecular pathology procedure results as a bundled service and not eligible for reimbursement effective with service dates on or after November 1, 2013.    

Tags: Pathology Billing & Coding


CAP Addresses Molecular Code Issues with CMS

  August 19, 2013 – In response to CMS’ recent decision to place molecular codes on the Clinical Laboratory Fee Schedule and the inconsistent pricing of molecular codes by the Medicare Administrative Contractors (MACs), the College of American Pathologists(CAP) addressed CMS with their concerns.   The following article was taken directly from the July 19, […]

Tags: Pathology Billing & Coding


Pathology and the 2014 Proposed Medicare Physician Fee Schedule (MPFS)

  July 30, 2013 – There are several provisions of the 2014 proposed Medicare Physician Fee Schedule proposed rule that will affect reimbursement to pathologists as of Jan. 1, 2014. Misvalued Codes CMS has proposed reductions in the technical component (TC) of 40 pathology codes that it considers misvalued, reducing reimbursement of some of the TC codes […]

Tags: Medical Billing, Pathology Billing & Coding, Physician Fee Schedule


CMS Proposes Major Changes to 2014 Clinical Laboratory Fee Schedule

  July 30, 2013 - Both the proposed 2014 Medicare Physician Fee Schedule (MPFS) and the Medicare Hospital Outpatient Prospective Payment System (OPPS) were released in the beginning of July and both included proposed changes to the Clinical Laboratory Fee Schedule. (CLFS)   For all fee schedules and systems within CMS (except for the CLFS), reimbursement rates are evaluated yearly and […]

Tags: Clinical Laboratory Fee Schedule, Medical Billing, Pathology Billing & Coding


AETNA Clarifies Labs that will Receive Rate Cuts July 1, 2013

6/27/2013 – In the May edition of our Pathology: Insurance Updates newsletter, we reported that Aetna will lower their reimbursement rates for lab services for all their products to equal only 45% to 50% of the national Medicare reimbursement rate as of July 1, 2013, stating it calculated its new rates based on “industry standard methodologies and […]

Tags: Pathology Billing & Coding


IL – ILLINOIS BCBS – Pathology Billing Updates

  6/27/2013 – Illinois BCBS has recently made some pathology billing updates to same day services. Coding Edits for Same Day Lab Services   BCBSIL has been enhancing their ClaimsXten code auditing tool by adding new rules to the claims processing system, using a phased approach.  The Same Day Lab Phase I was issued in […]

Tags: Pathology Billing & Coding


Labs Have Opportunity to Weigh-In on Molecular Code Fee Schedule

  5/30/2013 – CMS chose the gap-filling method to establish fees for the new molecular diagnostic CPT Codes. Gap-filling sets fees based on local pricing patterns, e.g., what labs current charge for the tests including discounts, what other payors reimburse for the same test, and what contractors pay for similar tests. CMS set a deadline in […]

Tags: Medical Billing, Pathology Billing & Coding


HARVARD PILGRIM (HPHC) Publishes Molecular Code Fees

  5/16/2013 – Effective May 1, 2013, HPHC updated its fee schedule for the new molecular codes (81200-81479) based on the rates published by Massachusetts’  local Medicare carrier, NHIC. Providers may request a sample fee schedule by calling HPHC’s Provider Services at (800) 708-4414.

Tags: Medical Billing, Pathology Billing & Coding


MA – BCBSMA – New Instructions for Monitoring Molecular and Genetic Tests

  5/16/2013 – In the fall of 2013, BCBSMA will ask ordering clinicians and testing laboratories to use McKesson’s online Clear Coverage application to supply them with data for genetic tests and molecular diagnostic services. BCBSMA states the data will provide information on which tests are being ordered and why and will help reduce the […]

Tags: Medical Billing, Pathology Billing & Coding


AETNA Lowers Lab Fee Schedule

  5/16/2013 – Effective July 1, 2013, Aetna will lower their reimbursement rates for lab services for all health plans to equal only 45% to 50% of the national Medicare reimbursement rates, according to an article in the April 2013 edition of Laboratory Economics.  Aetna states that it calculated its new rates based on “industry […]

Tags: Medical Billing, Pathology Billing & Coding


Pathologists May Earn Additional 0.5% in Medicare MOCP Initiative

  May 1, 2013 – Pathologists may earn another 0.5% of their allowed Medicare charges in addition to the 0.5% earned through the PQRS incentive program by participating in the Maintenance of Certification Program (MOCP).   The MOCP is a continuous assessment program that advances quality and the lifelong learning and self-assessment of board certified […]

Tags: PQRS Incentive Program


COVENTRY/HEALTH AMERICA: Human Chorionic Gonadotropin

  April 12, 2013 – According to CMS policy, human chorionic gonadotropin (84702) is payable when billed with specific diagnoses. Coventry Health will follow CMS’ guidelines and will deny claims billed with code 84702 in the absence of one of the designated covered diagnoses identified in the NCD coding manual. Based on CMS IOM 100.03, […]

Tags: Medical Billing, Pathology Billing & Coding


PA – HIGHMARK BCBS – Adjusts Clinical Laboratory Fee Schedules

  3/22/2013 Effective as of service dates of March 4, 2013, Highmark adjusted its professional clinical laboratory fee schedule, which is based on the 2013 Medicare Clinical Diagnostic Laboratory Fee Schedule.  This change will impact clinical laboratory allowances for UCR, and the Premier Blue Shield and Keystone Health Plan West fee schedules. The reimbursement for […]

Tags: Medical Billing, Physician Fee Schedule


AETNA – New Pathology Coding Policy

  3/22/2012 – Effective 6/1/2013, Aetna will only allow code 87621 (Infections agent detection by nucleic acid (DNA or RNA); papillomavirus, human, amplified probe technique) to be billed three times per service date.  

Tags: Medical Billing, Pathology Billing & Coding


MA – MASS HEALTH – Drug Test/Screen Policy Update

  2/15/2013 – As of service date, January 1, 2013, Mass Health established new claim edits for quantitative drug tests billed on the same date of service as a drug screen service.  Denial 8304 (lab conflict w/each other on same day) will be the denial code shown on the EOB when quantitative drug tests are […]

Tags: Medical Billing, Pathology Billing & Coding


MA – MASS HEALTH – Drug Screen Policy Update

  2/15/2013 – Mass Health has established new claim edits for quantitative drug tests billed on the same date of service as a drug screen service, effective January 1, 2013. Some of the changes are: Confirmatory drug tests should be billed with procedure code 80102 – (drug confirmation, each procedure) Non-payment for drug screen tests […]

Tags: Medical Billing, Pathology Billing & Coding


MA – HARVARD PILGRIM – Molecular Pathology Codes Billing & Payment Policy

  01/23/2013 – HPHC is processing the new CPT codes (81200-81479) for Molecular Pathology .  HPHC has also established a pricing policy for these codes and has updated their standard fee schedules.  Since these are very new codes, HPHC will review benchmark pricing information and may make additional fee schedule updates later in 2013. Providers may […]

Tags: Medical Billing, Pathology Billing & Coding


Pathology and Independent Labs: Fee Changes in 2013

  12/31/2012 – In the 2013 Medicare Physician Fee Schedule (MPFS),CMS took the hatchet to pathology fees as they revalued the technical component (TC) of several important pathology codes. In addition, they reduced fees by 1% to cover the cost of the primary care fee increase, and applied another 1% reduction as part of the […]

Tags: Pathology Billing & Coding, Physician Fee Schedule, SGR and Medicare Fee Schedule


Molecular Pathology Codes: 2013 Reimbursement

  December 28, 2012 – In the 2013 Medicare Physician Fee Schedule (MPFS),CMS ruled that the new molecular pathology codes will be paid under the Clinical Laboratory Fee Schedule (CLFS) because these services do not ordinarily require interpretation by a physician to produce a meaningful result.  Most of the laboratory processes involved in performing these […]

Tags: Medical Billing, Pathology Billing & Coding


PATHOLOGY UPDATE: 88363 Billing for Retrieval of Archived Surgical Pathology Cases

  December 28, 2012 88363 Examination and selection of retrieved archival (i.e., previously diagnosed) tissue(s) for molecular analysis (e.g., KRAS mutational analysis). In 2011, CPT code 88363 was created to capture a pathologist’s findings following the identification and selection of appropriate tumor tissue from a previously diagnosed surgical pathology case.  This article is a reminder that […]

Tags: Medical Billing, Pathology Billing & Coding


New BCBS Guidelines Change Lab Billing

  December 28, 2012 – This past year all Blue Cross Blue Shield (BCBS) programs made changes to their Blue Card plans that affect how independent clinical laboratories must bill to be paid for their claims. The Blue Card plan is a national program offered through the BCBS Association that enables members of one Blue […]

Tags: Pathology Billing & Coding, Provider Contracting & Enrollment


A Quick Review of Cytopathology of Fine Needle Aspiration (Biopsy) (FNA)

  Summer 2012 – Clear and precise documentation of procedures and services performed assists our coders in determining the correct CPT code for billing.  One of the issues we find in pathology is the lack of documentation to determine whether we are able to bill code 88177 for an FNA performed on the same site […]

Tags: Medical Billing, Pathology Billing & Coding


Stage 2 EHR Meaningful Use (MU) for Pathology

  Summer 2012 – There are several provisions in the final Stage 2 EHR meaningful use (MU) ruling that address items of interest to pathologists.  One is an exemption that pathologists may use if they will not be ready to attest to MU in time to avoid the 2015 penalties.  Other provisions may provide benefits […]

Tags: EHR & Meaningful Use, Medical Billing, Pathology Billing & Coding


Pathology PQRS Update

  Summer 2012 – The proposed 2013 Medicare Physician Fee Schedule, which was released in August, did not include any new PQRS measures for pathologists. Pathologists will continue to report the established 5 PQRS measures in 2013. REMINDER:  Please document your services clearly for the measures you are or will be reporting, so AHS coders […]

Tags: Pathology Billing & Coding, PQRS Incentive Program


11 Year Moratorium of Medicare Payment for the TC of Physician Pathology Services to Hospital Patients Ends June 30, 2012

  Spring 2012 – In the final 2000 Physician Fee Schedule (PFS) regulation published on November 2, 1999, CMS implemented a policy to pay only a covered hospital[1] for the technical component (TC) of physician pathology services for fee-for service Medicare beneficiaries who are inpatients or outpatients of a covered hospital.  CMS stated that payment for […]

Tags: Medical Billing, Pathology Billing & Coding


Patient Access to Laboratory Tests

  Spring 2012 – In our world of instant access to information, access by patients to their medical records and test results have been granted through HIPAA and the EHR regulations.  However, there are those who want to be cautious in deciding what records and under what conditions patients’ health records should be released to […]

Tags: Medical Billing, Pathology Billing & Coding


PATHOLOGY ICD-10-CM CODING – What You Need to Know

3/31/2012 – CMS has announced a potential delay in ICD-10 implementation beyond October 1, 2013. But if you have not yet begun planning for this change, you are already behind schedule! Every specialty will be affected by the transition from ICD-9 to ICD-10. The wide range of diagnoses that cause referring physicians to order laboratory […]

Tags: ICD-10, Medical Billing, Pathology Billing & Coding


2012 Clinical Laboratory Fee Schedule

3/31/201 – Although pathologists and clinical laboratories appreciated Congress’ efforts to block the 27.4% cut in the Medicare reimbursement rate for 2012, they were not happy about the additional price tag put on the clinical laboratory fee schedule to help pay for it. In February, Congress passed and the President signed the Middle Class Tax […]

Tags: Medical Billing, Pathology Billing & Coding, SGR and Medicare Fee Schedule


Coding Special Stains

3/31/2012 – The CMS NCCI (National Correct Coding Initiative) Policy Manual has introduced new special stains policies that will impact coding and reimbursement for pathologists and laboratories. The descriptions of these changes are from the NCCI Policy Manual, effective January 1, 2012. Special Stains The unit of service of special stains codes 88312-88313 is each […]

Tags: Medical Billing, Pathology Billing & Coding


AETNA – Lab Panel Policy for 2013

  December 28, 2012 – Effective March 1, 2013, Aetna will change how they bundle lab codes into the more comprehensive panel code when a designated number of component codes are billed. For more information, refer to their Claims, Policy Information (Step 3), Claim Payment and Coding Policies, Laboratory Panels on Aetna’s provider website.  

Tags: Medical Billing, Pathology Billing & Coding


Connecticut Medicaid – Molecular Pathology Codes

  December 28, 2012 – The Department of Social Services (DSS) will add the new molecular pathology codes in the 81201-81479 range for reimbursement, but all will require prior authorization. (PA)  PA must be requested prior to the date of service and services will not be authorized retroactively. Due to the delay in receipt of […]

Tags: Medical Billing, Pathology Billing & Coding


PA – HIGHMARK BCBS – Authorization Needed for Gene Analyses

10/24/2012 – Effective Oct. 15, 2012, Highmark revised its list of outpatient procedures/services requiring authorization. The following procedure codes were added to the authorization list. 81280 –  Long QT Syndrome Gene Analyses   (E.G., KCNQ1, KCNH2, SCN5A, KCNE1, KCNE2, KCNJ2, CACNA1C,CAV3, SCN4B, AKAP, SNTA1, AND ANK2); Full Sequence Analysis 81281 –  Long QT Syndrome Gene […]

Tags: Medical Billing, Pathology Billing & Coding


NY – Empire BCBS – Drug Screening Codes – Billing Update

10/24/2012 –  Effective January 1, 2013, Empire will no longer reimburse qualitative drug screening codes 80100, 80101, and 80104.  Qualitative drug screening will only be eligible for reimbursement under codes G0431 and G0434. Both codes G0431 and G0434 will be eligible for 1 unit of reimbursement per date of service.  Use of code G0431 (direct […]

Tags: Medical Billing, Pathology Billing & Coding


ICD-10 Final Rule Issued

September 5, 2012 – On August 24, 2012, HHS issued the final rule concerning the transition from ICD-9-CM  to ICD-10-CM diagnosis coding.  As suggested in the proposed ruling in April 2012, HHS has finalized the year delay for the transition to ICD-10 coding from October 1, 2013 to October 1, 2014. Other options suggested by […]

Tags: Healthcare Reform, ICD-10, Medical Billing


EHR Stage 2 Final Rule Released

September 5, 2012 – On August 23, 2012, CMS announced the final rule for Stage 2 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs.  The rule specifies the Stage 2 criteria that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet in order to successfully participate in the EHR […]

Tags: EHR & Meaningful Use, Healthcare Reform, Medical Billing


EHR Stage 2 Ruling – Possible Exemptions for Anesthesiologists, Pathologists and Radiologists

September 5, 2012 – CMS has designated the specialties of anesthesiology, radiology and pathology as qualifiers for a new Scope of Practice exemption granted in the EHR Stage 2 ruling announced on August 23, 2012.   This exemption is aimed at eligible professionals (EPs) who: lack both face-to-face interactions with patients, and lack the need […]

Tags: EHR & Meaningful Use, Healthcare Reform, Medical Billing


CT MEDICAID – Prior Authorization for Molecular Codes

July 25, 2012 – The Department of Social Services is requiring a prior authorization (PA) for the billing of the new molecular codes that were added to the CPT Code set effectiveJanuary 1, 2012.  (CPT’s 81200 – 81408)  When there is a new code for the molecular pathology test being ordered, providers must request PAs […]

Tags: Medical Billing, Pathology Billing & Coding


UNITED HEALTHCARE – Billing Molecular Codes

July 25, 2012 – United Healthcare follows Medicare guidance on reporting Molecular and Pathology CPT Codes.  Claims for services that are covered by the new molecular CPT codes should be submitted with both the “stacking codes” and the new molecular codes.  The stacking codes will be processed for payment, while the new codes will be considered […]

Tags: Medical Billing, Pathology Billing & Coding


HIGHMARK BCBS (PA) – Update on Molecular Pathology Test Codes

May 17, 2012 – Effective April 1, 2012,  Highmark issued specific guidelines for non-facility providers to follow when billing molecular pathology test codes for Highmark Commercial and Medicare Advantage members. For commercial members, providers should report the appropriate molecular pathology procedures test codes that are valid for the service dates beginning on or after January 1, […]

Tags: Medical Billing


NJ – Horizon BCBS of New Jersey – Drug Screen Claims

March 15, 2012  – Horizon BCBSNJ, in a recent review of their processed claims, discovered that their claims processing systems have been allowing and reimbursing for multiple units for the drug screen services listed below: G0431- (Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter) or […]

AETNA – Qualitative Drug Screens

March 15, 2012 Effective Date:  June 1, 2012 Effective June 1, 2012, Aetna will require the use of either of the following codes and will reimburse for 1 unit, per patient encounter, of either code when qualitative testing methods are used. G0431- Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, […]

3 New PQRS Measures Available for Pathologists

February 16, 2012 – There are three new PQRS measures for Pathologists to report this year, bringing the total reportable pathology measures to five. These additions broaden the ability of pathologists to participate in the PQRS Incentive Program. The three new measures and their associated measure numbers are:  249 – Barrett’s Esophagus-the percentage of patients with esophageal […]

MA – Neighborhood Health Plan – Pathology Payment Policy Updates

February 16, 2012 -  NHP has developed or revised their Provider Payment Guideline for Laboratory and Pathology Services.  The guidelines may be accessed by clicking below: Laboratory and Pathology Services Payment Guidelines  

MA – Fallon Community Health Plan – New Reimbursement Arrangements for Non-Contracted Providers

February 16, 2012 – Fallon is implementing new payment arrangements for pathology, anesthesiology, emergency and ambulance services rendered by providers who do not contract with the plan.  This applies to their commercial HMO and FCHP Commonwealth Care members only and the changes are as follows: Emergency services: Fallon will pay the usual and customary fee. […]

BCBS of NE PENNSYLANIA – Immune Cell Function Assay

January 23, 2012 – Effective February 1, 2012, BCBSNEPA will add new policy statements to their coverage of immune cell function assay.  They will not provide coverage for use of the immune cell function assay under the following circumstances, stating they are considered investigational: To monitor and predict immune function after solid organ transportation For […]

MASS. MEDICAID – Drug Screen Code Changes

December 30, 2011 – Effective December 1, 2011, MassHealth will no longer pay for drug screen CPT Codes 80100 (Drug screen, qualitative; multiple drug classes chromatographic method, each procedure) and   80101 (Drug screen, qualitative; single drug class method (e.g., immunoassay, each drug class). Drug screen services should now be reported using HCPCs’ Codes: G0431 (Drug screen, […]

HARVARD PILGRIM (HPHC) – Molecular Pathology Codes

December 20, 2011 – Although 100 new molecular pathology codes (81200 – 81408) were established in the 2012 CPT Code manual, HPHC will not reimburse for these codes in 2012 as there are no industry standard pricing methods established for these codes.  Standard pricing methods are usually set via Medicare reimbursement rates.  Since, Medicare is […]

HIGHMARK BCBS (PA) Clinical Pathology Consultation Services Now Covered

September 21, 2011 – Beginning October 3, 2011, Highmark BCBS will consider consultative clinical pathology services eligible for payment if all of the following requirements are met:   The consultative services must: Be requested by the patient’s attending physician Relate to a test result that lies outside the clinically significant normal or expected range in […]

NEW JERSEY MEDICAID – Coverage and Reimbursement for Drug Screening Tests

September 21, 2011 – The following are changes in the New Jersey Family Care (NJFC) Medicaid policy regarding coverage for drug screening tests done by independent clinical laboratories, physicians, certain categories of nurses, and Independent Clinics.  All changes are effective as of October 1, 2011.   New Codes   G0434/G0434QW– Multiple-Drug Test Device (Multiple Drug Classes […]

AETNA – Clinical Pathology Consultation

September 21, 2011 – CPT code 80500, clinical pathology consultation, limited, without review of patient’s history and medical records, will be denied when billed with a code from range 80100 – 80299 (Therapeutic Drug Assays).  Modifier 59 will not override this edit.

UNITED HEALTHCARE – Laboratory Rebundling Services

August 17, 2011 – The Pathology Consultation section of this policy will be revised to add surgical pathology consultation codes 88321, 88323 and 88325 to the codes treated as included in an Evaluation and Management (E/M) code reported by the same pathologist or reference laboratory on the same date of service. Accordingly, consistent with CMS, […]

HIGHMARK BCBS – Pathology Codes Added to Prior Authorization List

July 20, 2011 – Effective October 3, 2011, Highmark will add 15 codes to its list of outpatient procedures/services requiring authorization.  The following are pathology codes that will require prior authorization: 84999 – Unlisted chemistry procedure 89240 – Unlisted miscellaneous pathology test

United Healthcare Reporting of Modifiers 76 and 77 with Laboratory Services

July 20, 2011 – Duplicate laboratory codes reported with modifiers 76 (Repeat procedure or service by same physician or other health care professional) or 77 (Repeat procedure or service by another physician or other qualitied health care professional) will no longer be reimbursed.  This aligns with CMS’ policy which denies laboratory services when reported with either modifier […]

AETNA – Epstein-Barr Viral Capsid Antigen(VCA) Antibody (IGA)

June 16, 2011 – Effective September 1, 2011, procedure code 86665 (Epstein-Barr (EB) virus, Viral Capsid Antigen(VCA) ) will be allowed three times per date of service.

CMS – Withdrawal of Lab Physician Signature Requirement

May 19, 2011 – In the November 29, 2010, Medicare Physician Fee Schedule final rule, CMS finalized its proposed policy to require a physician’s or qualified non-physician practitioner’s signature on requisitions for clinical diagnostic laboratory tests paid under the clinical laboratory fee schedule, effective as of January 1, 2011. (This policy does not affect physicians paid under […]

AETNA-Reimbursement for Non-participating Services

April 20, 2011 – Beginning August 12, 2011, if the referring physician does not obtain precertification, Aetna will no longer cover the in-network benefits level for services provided by non-participating: Radiologists Pathologists Anesthesiologists Independent laboratories The policy applies to services performed in an office or independent laboratory setting only. Even if patients have out-of-network benefits, […]

Medicare – Removal and Addition of Test Codes – CLFS Fee Schedule

April 20, 2011 – Effective April 1, 2011, CMS updated the status of the following test codes on the Clinical Laboratory Fee Schedule (CLFS): DELETED:  G0431QW – Drug screen qualitative; multiple drug classes by high complexity test method.  G0431 remains on the CLFS fee schedule but should not be reported with a QW modifier, which indicates a […]

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