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A1c blood test coding

Boris Posted Thu 22nd of March, 2012 15:27:09 PM

Hi. How to bill for in Podiatry office A1c testing? Thank you.

SuperCoder Answered Thu 22nd of March, 2012 15:37:55 PM

A1CNow+ CPT Code Information:
•83037: Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use.[5]
A1CNow+ is approved for use with either a capillary or venous blood specimen.

Note 1: CPT code 83037 may be billed when an A1C test is performed in a provider’s office using a device cleared by the FDA for home use. CPT code 83037 is not intended to report an A1C test result that is obtained in a patient’s home by the patient or family.[6]
Note 2: The QW modifier should be used when coding for Medicare and Medicaid beneficiaries. The QW modifier (83037QW) indicates that the test and laboratory have received a CLIA Certificate of Waiver. A1CNow+ has been categorized as a waived test under CLIA.[7]
Note 3: CPT code 83037 became available in 2006 and most insurers utilize this new code. Other insurers continue to use CPT code 83036. Check with local insurers to confirm the appropriate CPT billing code.

Method of Blood Collection CPT Code Information:[8]
•36416: Collection of capillary blood specimen (e.g., finger).
•36415: Collection of venous blood by venipuncture.
Pre-requisite for Testing
•CLIA Certificate of Waiver:[7]
◦A1CNow+® is classified as a CLIA waived test by the FDA.
◦A CLIA certificate is required any time a clinical laboratory test is performed; however, performance of waived category tests requires only a CLIA Certificate of Waiver.
◦Labs that perform waived testing must enroll in the CLIA program by obtaining the certificate, pay the certificate fee every two years, and follow the manufacturer’s instructions in performing clinical lab tests.
◦To apply for a Certificate of Waiver, go to www.cms.hhs.gov/clia, download CLIA application form (CMS-116), follow the instructions provided, and send it to the appropriate state agency.
◦A list of state agency addresses is also available on the internet at www.cms.hhs.gov/clia.

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