Julie Posted Tue 07th of February, 2017 14:48:12 PM
Last year Dept of Labor was paying for cpt 80300 for a POC cup urine test. This year they are denying 80300 saying that 80300 is not valid in 2017. Does anyhone know what code DOL is honoring this year (2017)?
Also do either 80300 or 80305 require a QW modifier in 2017?
Thanks in advance
SuperCoder Answered Wed 08th of February, 2017 04:33:16 AM
CPT code 80300 is deleted in the year 2017 that is why it is denied for the year. For Drug test(s), presumptive you can use the 80305-80307 series instead of 80300. Modifier QW is for Clia waived test- Append modifier QW to a laboratory test which has been waived from Clinical Laboratory Improvement Amendments requirements. It is compulsory to have CLIA number for such centers. If it is applicable to you procedure, then only append this modifier.
Julie Posted Thu 09th of February, 2017 12:47:54 PM
Thanks for your response.
I am aware of the coding change for 2017 for 80300 vs 80305. However, in my state of NM, Work Comp (WC) is always a year behind in code changes like this. NM WC is paying the 80300 code for 2017, but is allowing a higher amount this year vs the 2016 allowable. It is only Dept of Labor (DOL) that has denied the 80300 code for 2017 DOS. I have now billed 80305 for a 2017 DOS for the DOL patient in question, so will see if that pays.
SuperCoder Answered Fri 10th of February, 2017 02:04:12 AM
Yes, you are right. You can re-bill the CPT 80305 for DOL, so that they can pay. Also provide your medical document for support. And it is good if NM WC will pay the last year code. Kindly let us know for any further assistance. Good luck.