Pulmonology Coding Alert

Question: During a practice meeting last week, the subject of Clinical Laboratory Improvement Amendments (CLIA) waivers came up. We are currently not CLIA-waived, and we will discuss it again at next month's meeting. I was wondering if you could offer any input? Should we apply for a CLIA waiver?Nevada SubscriberAnswer: Whether or not the waiver is worth it is up to the individual practice. However, the practice is not allowed to perform many basic laboratory services without CLIA-waived status. So if the practice does not get the waiver, it could be missing out on possible pay for some simple screens. Example: Here are a few of the tests that have CLIA-waived status:• 81002 --" Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy• 82270 --" Blood, occult, by peroxidase activity (e.g., guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (i.e., patient was provided three cards or single triple card for consecutive collection)• 81025 --" Urine pregnancy test, by visual color comparison methods.• 85651 --" Sedimentation rate, erythrocyte; non-automated.• 83026 --" Hemoglobin; by copper sulfate method, non-automated.• 82962 --" Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use.• 85013 --" Blood count; spun microhematocrit.If your pulmonary medicine practice has CLIA-waived status, you can perform (and code for) these tests and others. For your practice to perform CLIA-waived testing, Medicare requires that you:• enroll in the CLIA program by obtaining a certificate• pay the certificate fee every two years• follow the manufacturers' instructions for the waived tests• notify your state agency of any changes in ownership, nae, address or director within 30 days, or if you wish to add tests that are more complex• permit inspections by a CMS agent, such as a surveyor from the state agency. (Your laboratory is not subject to a routine survey or inspection.)For more info: Check out the application for the CLIA waiver at http://www.cms.hhs.gov/cmsforms/downloads/cms116.pdf.-- Answers to Reader Questions were provided and reviewed by Bruce Rappoport, MD, CPC, CHCC, a board-certified internist and medical director of Broward Health's Best Choice Plus and Total Claims Administration in Fort Lauderdale, Fla;, Robert B. Burleigh, CHBME, of Brandywine Healthcare Services in West Chester, Penn.; Kent J. Moore, manager of the Health Care Financing and Delivery Systems for the American Academy of Family Physicians; and Richard Tuck, MD, FAAP, with PrimeCare of Southeastern Ohio in Zanesville.