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Pediatric Coding Alert

Reader Questions:

Include Nasal Swab in Pre-Flu Test Work

Question: A pediatrician performs the QuickVue Influenza test in the office. Should she code for acquiring the specimen? To obtain the specimen, the physician takes a swab from the nasal cavity.

New Hampshire Subscriber
Answer: CPT doesn't contain a code for taking a nasal-swab specimen. You should consider the work involved in swabbing the nasal cavity as part of the E/M service (99201-99215, Office or other outpatient visit for the evaluation and management of a new or established patient ...).

Reminder: The QuickVue Influenza test is a Clinical Laboratory Improvement Amendments-waived test. So most insurers will want you to append modifier -QW (CLIA waived test) to the test code (87804, Infectious agent antigen detection by immunoassay with direct optical observation; influenza).

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