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Family Practice Coding Alert

Reader Questions:

Include Pre Flu-Test Work in E/M

Question: When a family physician (FP) performs the QuickVue Influenza test in the office, may he also bill 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 service for the evaluation and management of a new or established patient ...).
Reminder: The QuickVue-Influenza test is a Clinical Laboratory Improvement Amendments (CLIA)-waived test. So you must 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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