Compliance Question of the Week – Laboratory

Does the hospital still have the option to bill Medicare for the test if all of the conditions for the new laboratory DOS exception are met?

How have immunology codes 86255 and 86256 changed in recent years?

What codes would I use to report direct and amplified probe techniques in the code series 87260–87999?

How many units of service should be assigned for performing an infection agent technique such as mentioned in last week’s answer?

What codes can be assigned to identify infectious agents?

What are Medicare contractors looking for when they review orders for diagnostic laboratory tests?

For the CMS date of service policy update, does the date performed apply to molecular testing that is done in-house for Medicare outpatients, or is it only for testing that is sent to a reference lab, which must bill?

We operate CLIA moderate-complexity laboratories. Our testing menu offers several otherwise CLIA-waived tests (e.g., influenza testing, Strep A testing, certain chemistry analyses) in addition to some moderate-complexity testing such as a complete blood count and blood gases.

Are we REQUIRED to use a -QW modifier on those waived tests, or are we simply ALLOWED to use the modifier but not otherwise required?

The recommended practice is to confirm a new patient’s blood type with a repeat blood draw and retype done on the new specimen. This is only for a new patient or a patient who does not have type information already in the system. Is it appropriate to bill for the second blood type on a new patient, or is this considered confirmatory testing?

What codes are reported for urine drug definitive testing, and how many UOS should be reported?

I know that urine drug presumptive testing may be reported with CPT codes 80305–80307, but I do not know how many units of service (UOS) should be reported. Can you help?

Can CPT code 83721 (lipoprotein, direct measurement; direct measurement, LDL cholesterol) be used to report a calculated LDL cholesterol?