Wiki QW and billing 87804.....

[nneecole44]

Please help.

1. I work at a clinic that has a moderate complexity CLIA approved in house lab. I am a bit confused by the QW modifier. Do we still need to use the QW on Flu and strep swabs and urinalysis?

2. How are you getting paid for the 87804 (flu swab A and B)? I have always billed 87804-91 and 87804 and it paid. I am getting rejections on the modifier. Should I use 76, 59 or 87804 x2? Possibly XU? I am at a loss.
Thank you for your time.

 

[OpenClaims]

For the flu lab, it sometimes depends on the situation with the testing. This link has a great chart for this testing:Article - Billing and Coding: Influenza Diagnostic Tests (A54769)

For the QW modifiers, there are a select few labs that won't get the WQ modifier. Here is a link to the pdf from CMS. https://www.cdc.gov/clia/docs/tests-granted-waived-status-under-clia.pdf

 

[rthomas@impcna.com]

Please help.

1. I work at a clinic that has a moderate complexity CLIA approved in house lab. I am a bit confused by the QW modifier. Do we still need to use the QW on Flu and strep swabs and urinalysis?

2. How are you getting paid for the 87804 (flu swab A and B)? I have always billed 87804-91 and 87804 and it paid. I am getting rejections on the modifier. Should I use 76, 59 or 87804 x2? Possibly XU? I am at a loss.
Thank you for your time.

My clinic is also has a moderate complexity CLIA approved in house lab. This is how we bill and have never had an issue.
87804 QW
87804 XU;QW