Need some guidance with new drug code G0477. We hold a current CLIA certificate for provider-performed microscopy procedures. Can we bill G0477 with the QW modifier when it goes into effect in April?
We had found MM9502 dated 1/1/2016 that states "The HCPCS codes listed in table 2 (G0477 is listed) below, are new codes for 2016 and are subject to CLIA edits. The list does not include new HCPCS codes for waived tests or provider-performed procedures. .............. The following facilities are not permitted to be paid for these tests: ........3. A facility with a current CLIA certificate for provider-performed microscopy procedures (Certificate type code 4.). We also found MM9515 dated 1/15/2016 that does list G0477-QW, but I was not sure if this applies to us since we hold the PPM certificate.
I did read the previous thread on G0477, but it didn't address the PPM certificate.
Thanks in advance for any help in this matter.
We had found MM9502 dated 1/1/2016 that states "The HCPCS codes listed in table 2 (G0477 is listed) below, are new codes for 2016 and are subject to CLIA edits. The list does not include new HCPCS codes for waived tests or provider-performed procedures. .............. The following facilities are not permitted to be paid for these tests: ........3. A facility with a current CLIA certificate for provider-performed microscopy procedures (Certificate type code 4.). We also found MM9515 dated 1/15/2016 that does list G0477-QW, but I was not sure if this applies to us since we hold the PPM certificate.
I did read the previous thread on G0477, but it didn't address the PPM certificate.
Thanks in advance for any help in this matter.